Reproductive Health in Developing Countries Expanding Dimensions, Building Solutions (1997) / Chapter Skim
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Appendices
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235 APPENDIX A WHO Recommendations for Treatment of STD-Associated Syndromes In 1991, the World Health Organization (WHO)
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236 APPENDIX A Note. The therapies for uncomplicated gonorrhea, syphilis, chancroid, and granuloma inguinale are all described in Section 3 (World Health Organization/UNAIDS, 1997)
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RECOMMENDATIONS FOR TREATMENT OF STD-ASSOCIATED SYNDROMES 237 FI G U R E A -1 A lg or it hm f or t he m an ag em en t of u re th ra l d is ch ar ge .
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238 APPENDIX A FI G U R E A -2 A lg or it hm f or t he m an ag em en t of u re th ra l d is ch ar ge ( w it h m ic ro sc op e)
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RECOMMENDATIONS FOR TREATMENT OF STD-ASSOCIATED SYNDROMES 239 Note. This regimen should only be used in areas where trimethoprim/sulfamethoxazole has been shown to be effective against uncomplicated gonorrhoea.
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240 APPENDIX A Recommended regimens (see Figure A-3) therapy for syphilis plus either therapy for chancroid or therapy for granuloma inguinale Genital ulcer and HIV infection In HIV-infected patients, prolonged courses of treatment may be necessary for chancroid.
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RECOMMENDATIONS FOR TREATMENT OF STD-ASSOCIATED SYNDROMES 241 FI G U R E A -3 A lg or it hm f or t he m an ag em en t of g en it al u lc er s.
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242 APPENDIX A FI G U R E A -4 A lg or it hm f or t he m an ag em en t of in gu in al b u bo .
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RECOMMENDATIONS FOR TREATMENT OF STD-ASSOCIATED SYNDROMES 243 healthy skin. Incision and drainage or excision of nodes will delay healing and is contraindicated.
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244 APPENDIX A FI G U R E A -5 A lg or it hm f or t he m an ag em en t of s cr ot al s w el lin g.
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RECOMMENDATIONS FOR TREATMENT OF STD-ASSOCIATED SYNDROMES 245 Adjuncts to therapy Bed rest and scrotal elevation until local inflammation and fever subside. VAGINAL DISCHARGE Vaginal discharge is most commonly caused by vaginitis, but it may also be the result of cervicitis.
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246 APPENDIX A FI G U R E A -6 A lg or it hm f or t he m an ag em en t of v ag in al d is ch ar ge .
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RECOMMENDATIONS FOR TREATMENT OF STD-ASSOCIATED SYNDROMES 247 FI G U R E A -7 A lg or it hm f or t he m an ag em en t of v ag in al d is ch ar ge ( w it h sp ec u lu m )
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248 APPENDIX A FI G U R E A -8 A lg or it hm f or t he m an ag em en t of v ag in al d is ch ar ge ( w it h sp ec u lu m a nd m ic ro sc op e)
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RECOMMENDATIONS FOR TREATMENT OF STD-ASSOCIATED SYNDROMES 249 Alterative regimen where single dose therapy for gonorrhoea is not available trimethoprim (80mg) / sulfamethoxazole (400mg)
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250 APPENDIX A rhagia, dysuria, pain associated with menses, fever, and sometimes nausea and vomiting. PID is difficult to diagnose because clinical manifestations are varied.
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RECOMMENDATIONS FOR TREATMENT OF STD-ASSOCIATED SYNDROMES 251 FI G U R E A -9 A lg or it hm f or t he m an ag em en t of lo w er a bd om in al p ai n.
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252 APPENDIX A gentamicin, 1.5 mg/kg by intravenous injection every 8 hours.
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RECOMMENDATIONS FOR TREATMENT OF STD-ASSOCIATED SYNDROMES 253 doxycycline, 100mg orally, twice daily, or tetracycline, 500mg orally, 4 times daily for 14 days plus metronidazole, 400-500mg orally, twice daily for 14 days.
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254 APPENDIX A FIGURE A-10 Algorithm for the management of neonatal conjunctivitis. SOURCE: World Health Organization/UNAIDS (1997)
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RECOMMENDATIONS FOR TREATMENT OF STD-ASSOCIATED SYNDROMES 255 FIGURE A-11 Algorithm for the management of neonatal conjunctivitis (with microscope)
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256 APPENDIX A REFERENCES World Health Organization 1991 Management of patients with sexually transmitted diseases: Report of a WHO Study Group WHO Technical Report Series, No.
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PROGRAMS TO PROMOTE SAFE PREGNANCY AND DELIVERY 257 257 APPENDIX B Examples of Programs to Promote Safe Pregnancy and Delivery This appendix describes several projects that involve interventions ateach step of the process of care for obstetric complications outlined in Chapter 5. We present these descriptions because they illustrate concretely some of the principles discussed in the chapter, because many of the reports are not widely available, and because the published literature still contains few evaluations of outcomes.
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