Sexually Transmitted Infections

Sexually Transmitted Infections are infections that are caused by bacteria, viruses or Protozoans (flagellates) and are mainly transmitted through sexual contact from one individual to the sexual partner (s). All bacterial STIs can be easily treated and cured using specific antibiotics.It is important for early Health seeking behavior for treatment of STIs to avoid complications. Sexual Partner treatment is of significant importance to avoid recurrence/ repeated infections. Treatment of STIs during pregnancy prevents mother to child transmission. Most of Viral STIs do not have cure.

Causative organism for STIs

Mode of Transmission

• Sexual contact with infected partner ( vaginal, anal, oral )
• Mother to child transmission during pregnancy
• During delivery ( Perinatal )

Signs and symptoms

Most STIs presents themselves as syndromes having collective of similar clinical manifestation. Most commonly bacterial, protozoan and candidal STIs presents with either vaginal discharge in females or urethral discharge in men ( gonorhoea, chlamidia, Trichomoniasis and candidal vaginitis). The discharge varies from whitish, yellow or greenish with or without pain during urination. In a complicated condition in females there will be lower abdominal pains, this case of Pelvic inflammatory disease (PID).

Some bacterial infections presents with genital ulcerations with or without enlarged lymph nodes ( Syphilis, Chancroid, Lymhogranuloma venerum).

Acute Viral STIs presents with general symptoms of fevers, general body weakness, skin rashes, jaundice with or without enlargement of liver and lymph nodes (HIV, HPB). Chronic viral STIs presents with vesicular lesions, ulcers or warts/growth on the genital area for both males and females. More than 40%of population are infected with common viral infection and remains without symptoms but are able to transmit viral infection to their sexual partners. In Botswana 17.1% population are infected with HIV and about 30% are infected with HSV. These infections are more common with women and men of reproductive age groups. Both genital herpes ulcers and genital warts are prone to recurrences especially when are associated with co-existence of HIV.

Treatment

Most of bacterial STIs are treatable with the use of antibiotics Viral STIs can be treated to alleviate symptoms but do not have cure. The use of antiretroviral therapy helps to improve health, prevent recurrence and complications and prolong life particularly in HIV/AIDS.

Prevention

All sexually transmitted infections are prevented in similar ways to control transmission of infection to the sexual partner and spread of infection in the community. Like any infectious disease STI can be prevented:

• Primary prevention- Prevention of occurrence of infection through safer sex practices – “ABC” and Male circumcision preferably at neonatal age. Screening of Blood and safer injections and safer blood transfusion. Regular and routine screening for syphilis, HIV, HPB and HPV- Pap smear. Use of vaccine ( HBV, HPV), Hepatitis b vaccine is available in Botswana.
   
• Secondary prevention- Prevention of  STIs complications when infection has occur, this includes early health seeking behavior, early treatment of both clients and sexual partners, adherence to prescribed treatment of all STI conditions, abstaining from sex while on treatment or use of condom until cured, avoiding contacts with infected blood or body fluids. Screening and early treatment of STIs for pregnant mothers including Syphilis screening, HIV and Hepatitis B.
   
• Tertiary prevention: Prevention of death when STI Infections have been advanced to complicate vital organs (Syphilis, HIV/AIDS, Cervical cancer, liver cancer). Antiretroviral therapy, radiation therapy, surgical treatment and other palliative care method are used to prevent pain and suffering at this stage.

Some of the common Bacterial STIs are

• Syphilis
• Chancroid
• Lymhogranuloma venerum
• Gonorrhoea
• Chlamydia

Some common VIRAL STIs

• Human Immune deficiency Virus (HIV)
• Human Papilloma Virus (HPV)