)))))National Guidelines for the Management of STIs Using the Syndromic Approach
)))))This reference manual is designed to serve as the “text” for the participants and the “reference source” for the trainer. It includes introduction and nine modules. The introduction part elaborates the national and global burden of STIs and the content of each module. The Nine modules explain the concept and principles in STIs case management, and the steps in the diagnosis and management of STIs cases based on the syndromic approach.
)))))))))This trainer’s guide is designed a resource for trainers who lead training in STIs syndromic management. It contains all the instructions and materials needed to enable trainers to help trainees develop the knowledge and skills necessary to provide high quality STIs services. The trainers guide contains the following: approaches to be used during facilitation of sessions, information on the training package and the content of each training modules, a trainers checklist that details things to consider during preparation for the training, information on skills required for facilitation and principles of adult learning, course schedule and outline, instruction for all exercise and activities by module, information on course evaluation and key to pretest and posttest questioners , presentation slides.
)))))))))))Note: All files are in pdf format. Right-Click and select Save Taget As... menu to download the files.
Published by: Ministry of Health (MoH)
Sexually transmitted infections (STIs) are the most common causes of illness
in the world and have far reaching health, social and economic consequences.
STIs are important because of their magnitude, potential complications and their
interaction with HIV/AIDS. STIs are caused by more than 30 different pathogens
including bacteria, viruses, protozoa, fungus and ecto-parasites. The common
classical curable STIs are gonorrhea, chlamydial infection, syphilis, chancroid,
trichomoniasis and lymphogranuloma venereum and the preventable but not curable
are the viral STIs, which include human immunodeficiency virus, human papilloma
virus, hepatitis B virus, and herpes simplex virus. The main mode of transmission
of STI is through unprotected penetrative sexual intercourse, other modes are
mother-to-child, blood transfusions or contact with blood or blood products
and also individuals who frequently change partners are commonly affected. Identification
of STI pathogen(s) using laboratory tests is not feasible in most health facilities.
World Health Organization (WHO) has developed a syndrome-based approach to provide
health workers with a tool for improving the diagnostic process. The past medical
and sexual history is important to assess the risk behavior of patients with
STI.
STI prevention and control programs shall have three main objectives, these are, preventing the development of diseases, complications and sequelae; interrupting the transmission of STIs; and reducing the risk of HIV infection. STI surveillance is considered by WHO/UNAIDS to be a key component of HIV/AIDS surveillance. The five components of STI surveillance that are necessary for effective control programs are STI case reporting, periodic prevalence assessment and monitoring, assessment of STI syndrome etiologies, periodic or continuous monitoring of antimicrobial susceptibility, special studies on STIs behavioral surveillance. For surveillance purposes, the most useful STI syndrome is male urethral discharge. Urethral discharge and genital ulcer (non-vesicular) syndromes have been included on the integrated disease surveillance monthly reporting format of the MOH. Good STI incidence and prevalence data can contribute significantly to tracking trends in risky sex and potential exposure to HIV infection, and to monitoring the success of measures aimed at promoting safe sex.
STIs are major public health problems in all countries, but are especially so in developing countries where access to adequate diagnostic and treatment facilities are very limited or non-existent. Ethiopia is one of the countries most affected by the HIV/AIDS epidemic in Sub-Saharan Africa. The adult HIV prevalence in 2005 is estimated at 4.7%, and 1.7 million people are believed to be living with HIV/AIDS. The most serious health consequences of STIs, other than HIV/AIDS, tend to occur in women and newborn children. Conventional STI increases vulnerability for HIV infection. The majority of the complications of STIs are preventable if the patient is diagnosed and treated early. All patients should understand that STIs are preventable and that prevention may be achieved by abstaining from sexual activity by having sex with an uninfected lifelong mutually faithful partner or by using condoms correctly during every sex act. The objective of treatment of STI is to prevent complications arising from STI and to prevent transmission of the infections in the community.
Cognizant of the importance of controlling STIs as a major public health intervention and in view of making the syndromic approach a standard practice in all health institutions of the country, the MOH developed national guidelines in December 2001. The primary objective of these guidelines is to improve care and treatment of patients with conventional STIs. In 2003, EHNRI and FMOH in collaboration with CDC-Ethiopia and MSF-Belgium conducted a study to validate the performance of the syndromic management algorithms for the major STI syndromes that would help in revising the guidelines.