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  • Title: Sexually transmitted diseases.
    Author: Program for Appropriate Technology in Health PATH.
    Journal: Health Technol Dir; 1988; 8(1):1-11. PubMed ID: 12315909.
    Abstract:
    Management of sexually transmitted diseases for developing countries is reviewed with special attention to appropriate technology, with sections on diagnosis, treatment, prevention, and program issues. Brief descriptions of gonorrhea, chlamydia, syphilis and chancroid are provided. Some diagnostic techniques can be adapted effectively to remote locations, i.e., microscopy, dark field microscopy, and some serological tests. The VDRL test for syphilis, agglutination tests and ELISA (enzyme-linked immunoassay) screens for AIDS, chlamydia or gonorrhea can be done without electric power. Some serological tests may be adapted by collecting and transporting blood on filter paper. No culture techniques can be controlled well without reliable electric power and fairly expensive equipment. The most practical type of diagnosis for remote areas is the WHO syndromic approach. This is a standardized decision tree which incorporates therapeutic tests using antibiotics. The advantages are immediate initiation of treatment, and no need for laboratory backup, although lab tests would help consolidate diagnoses, if available. The most problematic aspect of treatment of STDs is drug resistance of the causative organisms. Since the STDs cause similar symptoms, and diagnosis may be uncertain or a client may have more than one infection, it is best to treat the disease causing the most frequent, severe and costly complications 1st. Thus, syphilis is treated 1st because of its adverse complications; chancroid is treated 2nd because of its pain. Contact tracing by patients, health education, use of condoms, diaphragms with spermicide, and silver nitrate or erythromycin for newborns' eyes are examples of feasible prevention measures.
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