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  • Title: Prevention of PID: a challenge for the health service.
    Author: Brabin L.
    Journal: Ann Trop Med Parasitol; 1992 Aug; 86 Suppl 1():25-33. PubMed ID: 1489243.
    Abstract:
    The control of sexually transmitted diseases (STD) will reduce the prevalence of pelvic inflammatory disease (PID). In most developing countries, treatment services are limited, coverage of the infected female population is inadequate and women seeking treatment are likely to be mismanaged. Family planning clinics do not usually provide routine screening for non-pregnant women. Screening only at family planning clinics would result in failure to treat some high-risk individuals, especially unmarried adolescents. The use of simplified protocols in the community has been recommended, but these may underestimate the problems of contact tracing, provide no systematic screening and induce passivity in the patient. For pregnant women, STD control has targetted syphilis, which does not cause PID. An integrated service for the management of reproductive health is required, and the development of women's clinics is suggested, using well-trained nurses and affordable technologies. The long-term sequelae of infection with sexually transmitted disease (STD) are most serious in women. The high incidence of STD complications and sequelae results partly from a lack of resources for adequate diagnosis and treatment, but also from the absence of any clear policy for improving gynecological morbidity. Although effective STD programs could reduce gynecological morbidity, STD control is most concerned with controlling the spread of HIV and the treatment of STDs which contribute to high perinatal mortality rates. The author discusses the objectives of current approaches to STD control and how programs affect women. Controlling STDs could reduce the prevalence of pelvic inflammatory disease (PID). In most developing countries, however, treatment services are limited, coverage of the infected female population is inadequate, and women seeking treatment are likely to be mismanaged. STD control for pregnant women has targeted syphilis which does not cause PID. Family planning clinics do not usually provide routine screening for non-pregnant women. Even if routine screening were offered, screening only at family planning clinics would result in the failure to treat some high-risk individuals, especially unmarried adolescents. The use of simplified protocols in the community has been recommended, but they may underestimate the problems of contact tracing, provide no systematic screening, and induce passivity in the patient. Integrated services to manage reproductive health is instead suggested along with the development of women's clinics using well-trained nurses and affordable technologies.
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