SEXUALLY TRANSMITTED
INFECTIONS/DISEASES
Presented by:
Dr. Nicholas Ochieng
Lecturer, Department of Clinical
Medicine
KMTC - Nairobi
LESSON OUTLINE
In this lesson, we shall discuss:
Background
Epidemiology
Modes of spread
Common types of STIs
Clinical presentation
Complications of STIs
Prevention & Control
Background information
STIs occur globally and affects people of all
races
The occurrence was 1st reported in the
Medieval period (5th – 15th Century)
when it was believed to have been
introduced into Europe by explorers & later
to Africa
More than 30 different organisms have
been shown to be transmitted sexually
Background Info Cont
Why was the name changed from STDs to
STIs? According to the American Health
Association, it was changed because:
The experts wanted STIs description to
be more accurate, because all STIs are
infections
To address the stigma associated with
STDs
STIs have clear signs & symptoms
Background info Cont
STIs can also be transmitted by non-
sexual means eg blood and its
products
Only a small no (8) are curable while
others are not curable but their
course can be modified by treatment
QUIZ ON MYTHS OF STIs
True or False
1. Most people with an STD (STI) experience
painful symptoms.
2. Birth control pills prevent the spread of STDs.
3. Douching will cure and STD.
4. Abstinence is the best way to prevent STDs.
5. If you get an STD once, and are treated, you
can’t get it again.
6. A person does not need to see a doctor if she/he
notices scores on his/her genitals once, but then
they go away.
7. Condoms do not help prevent the spread of
STIs
Epidemiology of STIs
More than 1 million people acquire a
sexually transmitted infection (STI)
every day & an estimated 500 million new
cases of curable STIs occur yearly
Examples are - gonorrhoea, chlamydia,
syphilis and trichomoniasis
In addition, 536 million people are
estimated to be living with incurable herpes
simplex virus type 2 (HSV-2) infection
but HSV-1 can sometimes cause STI
Epidemiology Cont
Approximately 350 million women have
Human papilloma virus (HPV)
infection at any given point in time
worldwide, so what is the danger?
Majority of STIs have no symptoms
and signs so are diagnosed by chance
Epidemiology cont
STIs like Syphilis and Herpes
genitalis predispose people to HIV
infection
Gonorrhoea has proved to develop
resistance to antibiotics easily (eg to
Penicillins, Quinolones, Erythromycin
& Cephalosporins)
This is a picture of what STI?
MODES OF SPREAD OF STIs
STIs are spread from person to person
through:
– Sexual intercourse
oral-genital contact or
– Non-sexual ways – that include:
IV drug use - even for drug addicts
Administration of blood & blood products
– During delivery (From mother to baby)
The 1st 2 modes are ski-to-skin contact
Common Symptoms
The common symptoms include:
Ulcers (either painful or painless)
Unusual discharge
Passage of blood in urine
Swelling of inguinal lymphnodes
Burning sensation when urinating
Rashes
Itching
Bumps
Warts
Lower abdominal/back pains
Which STI is due to infestation
by the insect below?
Pubic lice
Skin rashes on the genitals
Transmission fluids
Which of these fluids can transmit STIs?
Semen
Vaginal fluid
Blood
Fluid in sores or blisters
Which of these fluids are
infectious?
Saliva
Tears
Sweat
Urine
Ear wax
Mucus
Classify the following
Into high, Low or No Risk Categories:
Abstaining Sharing of lip balm
Kissing Sharing of utensils
Holding hands Being massaged
Dancing Practice of monogamy
Hugging Dancing
Sitting on toilets Putting body tatoos
Types of STIs
Bacterial STI’s include:
Chlamydia, Chancroid, Granuloma
Inguinale, LGV, Gonorrhoea & syphilis
These can be treated and cured with
antibiotics
Untreated infections can cause
complications - PID, infertility, &
epididymitis
Q. What are their causative organisms?
Picture of Chancroid
Causes a dirty ulcer
Picture of Granuloma Inguinale
Types of STIs Cont.
Viral STI’s include:
HPV (warts), HIV, Herpes, Hepatitis B &
Molluscum contagiosum
There is NO cure for these group , but
medications are available to treat the
symptoms only
These STIs can be passed on to others
through out life
Parasitic STIs
These common examples are:
Scabies
Phythiriasis (Lice) &
TV, is also a parasitic STI
These can also be transmitted by other
means like close contact of skin to skin but
clinicians often do not remember them
However, they are curable with correct
medications
This is a child, but the dsx is
also an STI
New STIs
The organisms recently isolated include:
Mycoplasma genitalium
Shigella flexneri
Neisseriae meningitidis
These are now becoming more common, so
require investigations to confirm diagnosis
and manage accordingly
Possible Complications
If not treated, STIs can lead to following
complications:
Predispose people to HIV infection
Development of resistance to drugs
Becoming chronic
Impact on sexual and reproductive
health – premature deliveries, low-
birth weight babies, neonatal deaths,
etc
Complications Cont
Congenital birth defects (eg Hare-lip &
Cleft palate, CHDs, Hydrocephalus,
Spina bifida, etc)
Infertility
Cervical cancer Kidney Disease
PID Arthritis
Congenital syphilis Eye infections
(blindness) Liver disease
Prevention & Control
For prevention of STIs, remember the 4Cs
as for HIV infection
What are they?
1. ………………………………. Counseling
2. ………………………………….. Compliance
3. ……………………………………….. Condom
4. ………………………………………. Contact R/
Prevention Cont.
The additional measures include:
Abstinence from sexual intercourse
No sharing of injection needles
Have only 1 faithful sexual partner
Get screened for STIs & Treatment
Use of spermicides
Avoid alcohol & drugs abuse for the
youth
Health education
Control Measures
This can be achieved through:
Integration of STI services into existing
health systems
Advocacy to fight the stigma associated
with STIs in the society
Measurement of STI burden & surveillance
Regular screening of Expectant women
Summary
What have we discussed in this lesson?
………………………………………
…………………………………………….
……………………………………………………….
Questions??
Which STI organism is this?
Gonococcus
Practice Questions
1. Give 3 examples of the social and
economic effects of STIs?
2. List 5 possible complications of STIs on
reproductive health?
THE END
