Sexually transmitted diseases have been a major concern for many years infecting the most productive age of the population. The most affected people are young individuals with those between 15 to 24 years accounting for almost half of the patients. They include syphilis, gonorrhoea, chlamydia, and cancroid (Teri Moser Woo, 2016) . Some of these diseases have varying symptoms that can present inside or outside the body causing various effects to the patient. Healthcare professionals have suggested different diagnosis methods for each ailment to develop the best treatment. To offer a better understanding of STDs, the paper has concentrated on two such illnesses, namely syphilis, and gonorrhoea. It describes how they are diagnosed, the prevalence and treatment method of each. The paper also describes the educational plan and follow up for the patient regarding diagnosis.
Syphilis
Syphilis can be described as a systematic disease that is brought about by Treponema pallidum . This causative agent has been in the existence for many years causing the illness to be prevalent for centuries. One can contract the disease by coming into direct contact with the mucous tissues of an infected person. A person suffering from syphilis may start showing symptoms between five to ninety days after being exposed to it. They include ulcer, mucocutaneous lesions, and rash.
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Diagnosis
Syphilis diagnosis involves the use of various methods to produce a variety of results for more accurate treatment. The first one involves a direct detection method which involves physical observation of the causative organism(Hook, 2017). The healthcare professional can carry out dark-field microscopy, antibody testing, and PCR. They can carry out direct detection before other tests to produce better results. The second diagnostic method involves two types of serologic tests that involve the detection of antibodies or antigens which cause syphilis. The first one, referred to as the Treponemal test is used to confirm the presence of antibodies in the causative agent while the second one, Nontreponemal test is used to detect the presence of antigens.
In testing the presence of syphilis, there are various signs that manifest. However, the disease can imitate the symptoms of other illnesses. This has resulted in the testing methods undergoing various transformations over the years. In the early period, healthcare professionals used nontreponemal tests (VDRL and RPR) for screening purposes and clinical findings. If they turn positive, the second one, the confirmatory treponemal test is carried out. However, there has been an invention of advanced methods that are more efficient and cost-effective.
Prevalence
Syphilis remains one of the most prevalent Sexually Transmitted Diseases (STDs) in the world. According to the World Health Organization (WHO) statistics, around 37 million people were suffering from the disease. The body estimates the number of infections to be 12 million annually across the world. 90% of those cases mostly occur in developing countries with insufficient resources to fight the disease. Those statistics are the first reason why syphilis is a public health concern.
The second reason syphilis is a global health concern is its prevalence among HIV/AIDS patients. According to WHO, the disease is high to HIV positive patients at 6.4% as compared to those who have tested negative at 1.6 percent. This means that syphilis is likely to worsen the condition of AIDS patients and possibly cause early death. Another relation between the two diseases is that STD can increase the likelihood of contracting HIV/AIDS. It is estimated that the rate of acquiring the disease through sex is triple to five times in people suffering from syphilis as compared to those without. This means that it increases the spread of HIV/AIDS thus creating the need to come up with methods of curbing it faster.
Treatment
Syphilis requires early diagnosis and treatment to produce better results. Healthcare practitioners recommend the use of penicillin as the best medicine to kill the causative agent to this disease. The body reaction determines the effectiveness of this antibiotic thus the medical practitioner can suggest other drugs like tetracycline and doxycycline if the patient becomes allergic to the former. If the patient suffers from the primary or secondary stages of syphilis, the healthcare professional can administer a single dose of penicillin and suppress the effects of the disease(CDC, 2015). For a person suffering from the illness for more than a year, it would be advisable to treat it with more than one injection for efficient recovery. Penicillin also remains as the only form of treatment for pregnant women suffering from syphilis. The reason for this recommendation is that other drugs could significantly affect the pregnancy or cause serious physical deformities to the child. After one has received this treatment, he/she may experience symptoms and signs such as chills, headache, and fever, a condition referred to as Jarisch-herxheimer.
Education Plan and Follow-up for the Patient
After the healthcare professional has treated the patient, he/she needs to carry out an appropriate follow-up to ensure that the accurate intake of drugs is maintained and correct practices followed. The first step involves asking the patient to undergo regular blood tests with a view of checking the response to the penicillin dosage. Different forms of treatment have varying follow-up programs thus determining the number of tests one can take. The second step the patient should take involves avoiding having sex with an uninfected partner until he/she has fully recovered. This can be confirmed through a blood test which will indicate the presence or lack of syphilis. Third, the patient needs to inform his/her sexual partner so that he/she can be tested to avoid re-infection.
Gonorrhoea
Gonorrhoea is a disease caused by Neisseria gonorrhoeae and transmitted through vagina, urethra, pharynx, eye, or rectum. According to the Centre for Disease Control and Prevention (CDC) study, there are about 700,000 new infections annually in the United States. Gonorrhoea tends to affect men more with most of them showing symptoms in the early stages of the disease as compared to women. After one gets infected with the disease, he/she can develop infertility, tubal scarring, and ectopic pregnancy. Gonorrhoea is also followed by Chlamydia.
Diagnosis
Just like other STDs, gonorrhoea requires an earlier diagnosis to prevent its effect. A person can get tested even without showing any symptoms especially after having sexual intercourse. However, the test may take up to a week before the disease could be confirmed. To test the presence of gonorrhoea, a healthcare professional carries out different tests, the common one being swabbing the affected body parts. They may include vagina, rectum, or throat where causative bacteria may have accumulated. However, there are different diagnoses for men and women with each requiring a different strategy.
Prevalence
Gonorrhoea remains the most common form of STDs in the United States. It is the main contributor to the occurrence of Pelvic Inflammatory Disease (PID) which may cause serious effects on women like tubal infertility. This is the first reason why gonorrhoea is identified as one of the major public health concerns. According to the report by the CDC, there were around 484,000 cases of the disease in 2018 in the US. This was one of the highest annual figures have risen at an alarming rate from the previous year. Globally, the World Health Organization (WHO) put the figure to be around 87 million in 2016. The disease affected the most productive age group with those aged 15 to 49 years accounting for the bulk of this number(Rowley et al., 2019). This is another reason why gonorrhoea is one of the public health concerns.
Treatment
In treating gonorrhoea, a healthcare professional may propose two types of antibiotics namely azithromycin and ceftriaxone. Each of these is administered differently. For treatment using ceftriaxone, the medical practitioner may inject the patient a single dose which in most cases has a quantity of 250 milligrams. Azithromycin may be administered through the mouth where one is given a tablet which is also taken once. Each of these drugs is used to stop the effect of gonorrhoea and not reverse the damages made(Unemo et al., 2019). This is the reason why healthcare professionals advise people to seek medical care once they suspect infection. They also advise against the sharing of drugs to prevent side-effects or ineffectiveness on a person.
Follow-up
A person diagnosed and treated of rectal or urogenital gonorrhoea does not require to make confirmation of cure, unlike the pharyngeal one who has to see the healthcare professional after two weeks. The latter can undergo another diagnosis using either the Nucleic-Acid Amplification Test (NAAT) or the culture method. If the symptoms are still detected, the patient can receive a different form of treatment to suppress the disease. Healthcare professionals may also advise the patient to encourage his/her partner to get tested. This prevents one from reinfection or further spread.
Various Sexually Transmitted Diseases (STDs) have various effects on various aspects of life. They can lead to complications and feelings of guilt among those who suffer from them. The most common types of STDs are syphilis and gonorrhoea which affect a higher number of people across the world. For syphilis, diagnosis is done either through physical observation or serological tests while gonorrhoea requires swabbing the affected areas. In treating both, healthcare professionals can use different antibiotics to supress their symptoms.
References
CDC. (2015). Syphilis - 2015 STD Treatment Guidelines. U.S. Department of Health & Human Services .
Hook, E. W. (2017). Syphilis. The Lancet . https://doi.org/10.1016/S0140-6736(16)32411-4
Rowley, J., Hoorn, S. Vander, Korenromp, E., Low, N., Unemo, M., Abu-Raddad, L. J., … Taylor, M. M. (2019). Chlamydia, gonorrhoea, trichomoniasis and syphilis: Global prevalence and incidence estimates, 2016. Bulletin of the World Health Organization . https://doi.org/10.2471/BLT.18.228486
Teri Moser Woo, M. V. (2016). Pharmacotherapeutics for Advanced Nurse Prescribers. Philadelphia, PA: F.A Davis Company.
Unemo, M., Seifert, H. S., Hook, E. W., Hawkes, S., Ndowa, F., & Dillon, J. A. R. (2019). Gonorrhoea. Nature Reviews Disease Primers . https://doi.org/10.1038/s41572-019-0128-6
