STI and Community Control of STI's

Question 1

What causes Chlamydia and what is the main epidemiology and investigation?

Answer 1

• Chlamydia trachomatis (Gram -ve)
  Peak at 20 y/o and women > men
  Inv: NAAT Male: 1st void urine and Female: Vaginal swab

Question 2

What are the main symptoms, complications and site of infection for chlamydia in men?

Answer 2

Symptoms: Dysuria and Urethral discharge
- Epididymo-orchitis
Urethra –> Urethritis

Question 3

What are the main symptoms and site of infection for chlamydia for women/

Answer 3

Symptoms: Discharge, Dysuria and Menstrual irregularity (Over 70% asymptomatic)
-Cervix

Question 4

What are the main complications of chlamydia in women?

Answer 4

1) pelvic Inflammatory disease
2) Ectopic pregnancy
3) Infertility
4) Neonatal transmission (opthalmia neonatorum)

Question 5

What is the main treatment for chlamydia?

Answer 5

1) Partner notification and management
2) Test for other STI’s
3) Azithromycin/Doxycycline

Question 6

What is the cause and epidemiology of gonorrhoea?

Answer 6

Neisseria gonorrhoeae (Gram -ve diplococci)
Peak age 25-30
Males > Females

Question 7

What investigations and treatment are done for gonorrhoea?

Answer 7

Treat: Partner notification, test for other STI’s and Ceftriaxone IM with azithromycin
Inv: NAAT and Gram staining of male discharge/female swab

Question 8

What are the benefits of partner notification?

Answer 8

1) prevents re-infection
2) Prevents complications in asymptomatic contacts
3) breaks chain of infection

Question 9

What are the causes and epidemiology of syphilis?

Answer 9

C: treponema pallidum
Ep: High risk in MSM(oral sex), and men > women

Question 10

What are the main symptoms and investigations of syphilis?

Answer 10

1) Primary chancre (non-tender ulcer on genital skin, nipples and mouth
2) Genital ulcer = syphilis unless otherwise proven
INV: Serology

Question 11

What is the main treatment of syphilis?

Answer 11

penicillin (IM), follow up and partner notification needed

Question 12

What is primary prevention of STI’s?

Answer 12

Reduce risk of acquiring STI
- Awareness campaigns
= Hep B and HPV vaccinations
- 1:1 risk reduction discussions and reduce risk behaviour

Question 13

what is secondary prevention of STI’s?

Answer 13

Case finding

• Partner notification
• targeted screening (national chlamydia screening)
• Easy access to STI/HIV tests and treatment

Question 14

What is tertiary prevention of STI’s?

Answer 14

• Reducing morbidity and mortality
• Anti-retroviral for HIV
• acyclovir to suppress Herpes

Question 15

Describe the STI/HIV transmission model (May & Andersen 1987).

Answer 15

R = BCD.

R = reproductive rate.
B = infectivity rate.
C = number of partners.
D = duration of infection.