SupplementAdvances in control of sexually transmitted diseases in developing countries
Section snippets
Health education
In the first decade of the AIDS epidemic, considerable resources were devoted to primary prevention through health education, but there was little evidence that it affected sexual behaviour in developing countries. However, condom promotion through social marketing had some spectacular successes–eg, in Ethiopia, where condom sales increased in 5 years from less than 500 000 per year to nearly 20 million.12 Similarly, an intensive condom-promotion campaign in Thailand targeted brothel owners,
Syndromic management
A community-randomised trial in the Mwanza Region of Tanzania showed that improved clinical services for STDs, with the syndromic approach recommended by WHO in rural health centres and dispensaries, reduced the incidence of HIV infection by about 40% over 2 years.9 The intervention had five components: a reference STD clinic was set up as a training centre and to monitor the aetiology of STD syndromes and the antimicrobial susceptibility of local strains of Neisseria gonorrhoeae; healthcare
Barriers to effective STD control
Piot's operational model, originally developed to identify deficiencies in tuberculosis control programmes, has been adapted by Fransen and others to conceptualise the barriers to effective STD control (figure 2). Improved services such as those implemented in Mwanza can increase the proportion of STDs cured, but need to be supplemented by: primary prevention activities, behavioural interventions to improve treatment seeking behaviour, and efforts to identify and treat people with symptomless
Unmet needs
In this review we have highlighted the areas where advances have been made in recent years; there are many areas where more research and work are required. For example, STD control in both low-prevalence and high-prevalence areas would be greatly simplified with the development and distribution of low-cost, effective, and simple-to-use diagnostic tests for common STDs (such as gonorrhoea and chlamydial infection). These tests would not only be able to identify those symptomatic people with an
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Sexually transmitted infections: Progress and challenges since the 1994 International Conference on Population and Development (ICPD)
2014, ContraceptionCitation Excerpt :Among the four bacterial/protozoan STIs, currently, only syphilis has an inexpensive, rapid, point-of-care test that can be used in low-resource settings and can accurately determine the existence or absence of infection, meeting WHO’s Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment-free and Deliverable to end users (ASSURED) criteria for low-resource settings [44]. Trichomonas protozoan infection can be detected by collecting a specimen during speculum examination and identifying it under a microscope, and there is hope for development of new tests meeting ASSURED criteria [45]. ( Table 2).
Sexually Transmitted Diseases
2009, Encyclopedia of Microbiology, Third EditionGlobal control of sexually transmitted infections
2006, LancetCitation Excerpt :Even so, some world leaders would not allow a UN declaration to openly specify that men who have sex with men, sex workers, and injecting drug users needed specific interventions.4 All other sexually transmitted infections, which were high on the international policy agenda in the 1990s,5 now receive little attention, and are not named in the MDGs. Although diagnosis and treatment of sexually transmitted infections are now officially recognised as a low cost, neglected intervention by the Disease Control Priorities Project, they are considered only as a means of reducing the risk of HIV transmission.6
The Ever-changing Face of AIDS: Implications for Patient Care
2005, The AIDS PandemicThe ever-changing face of aids. implications for patient care.
2004, The AIDS Pandemic: Impact on Science and SocietyManagement of vaginal discharge syndrome: How effective is our strategy?
2004, International Journal of Antimicrobial Agents