Infestation and Treatment Quiz

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Questions and Answers

What is the recommended duration for leaving permethrin 1% on the affected area during treatment?

10 minutes (correct)

30 minutes

20 minutes

5 minutes

What is the advised duration for malathion 0.5% treatment application?

24 hours

5 hours

12 hours (correct)

48 hours

What is suggested after the initial application of lice treatment?

No further treatment needed

A retreatment after 14 days

A second application after 7 days (correct)

Immediate additional treatment

Which of the following treatments is recommended for pubic lice infestation?

Permethrin 1% Signup and view all the answers

Which area should be treated if pubic lice infestation is present?

Entire body, including facial hair Signup and view all the answers

What is a common symptom associated with pubic louse infestation?

Itching Signup and view all the answers

What is the minimum duration for antibiotic treatment of Donovanosis until the lesions have healed?

3 weeks Signup and view all the answers

Which antibiotic regimen is NOT mentioned as a treatment for Donovanosis?

Ciprofloxacin 500 mg daily Signup and view all the answers

Which method of screening should be included when diagnosing lice along with other STIs?

NAAT for N.gonorrhoeae Signup and view all the answers

What is a key recommendation for patients undergoing treatment for Donovanosis?

Abstain from sex for at least 3 weeks Signup and view all the answers

What does the 90-90-90 target established in 2014 aim to achieve concerning HIV treatment?

90% of people living with HIV know their HIV status Signup and view all the answers

What is the recommended follow-up procedure for patients treated for Donovanosis?

Follow up until lesions have fully resolved Signup and view all the answers

Which of the following is NOT a method of diagnosing Donovanosis?

Presence of Gram-positive bacteria in the lesions Signup and view all the answers

What type of staining is used to identify Donovan bodies in diagnostic samples?

Giemsa or Silver stains Signup and view all the answers

What is the primary causative agent of Donovanosis?

Klebsiella granulomatis Signup and view all the answers

Which of the following statements about the treatment of Donovanosis is accurate?

Patients must be monitored until wounds are healed adequately. Signup and view all the answers

What is the recommended single-dose regimen for the treatment of certain STIs?

Azithromycin 1 g orally Signup and view all the answers

What is the primary reason for using multiple-dose regimens for HIV patients?

Higher rates of treatment failure with single-dose therapy Signup and view all the answers

After initiating treatment for genital ulcers, when should patients follow up to monitor healing?

3-7 days Signup and view all the answers

What should patients be advised regarding sexual activity after starting treatment?

Abstain from sex for at least 7 days Signup and view all the answers

Which additional test should be performed alongside an ulcer swab for HSV?

HIV serology Signup and view all the answers

What should be monitored closely in HIV-infected patients undergoing treatment for genital ulcers?

Rate of healing Signup and view all the answers

Which oral antibiotic is recommended for a multiple-dose regimen for treating STIs?

Ciprofloxacin Signup and view all the answers

What is the purpose of genotyping C.trachomatis NAAT in the context of genital ulcers?

To identify specific strains involved in the infection Signup and view all the answers

Study Notes

Epidemiology and Pathogenesis of HIV/AIDS

More than 78 million people are estimated to have been infected with HIV since 1981.
39 million have died from HIV/AIDS.
In 2017, 36.9 million people globally were living with HIV, representing 0.8% of adults aged 15-49.
21.7 million accessed anti-retroviral therapy (ART).
ART has dramatically reduced HIV mortality, transforming it from a fatal infection to a manageable chronic condition.
Global HIV infections have decreased by 38% since 2001, but rates remain high in Eastern Europe and Central Asia.
HIV is a leading cause of disability-adjusted life-years for those aged 30-45 and a leading cause of death for women aged 15-49.

Transmission Routes

HIV is primarily transmitted sexually, through semen, cervical secretions, and blood.
Viral load is highest during acute infection and reduced by effective ART.
HIV acquisition risks are heightened by stigma, discrimination, gender-based violence and legal restrictions limiting access to services.
Heterosexual intercourse is the main route in many regions, including sub-Saharan Africa.
Transmission is more efficient from men to women and during receptive anal intercourse.
Males' circumcision reduces HIV acquisition and transmission.

Vertical Transmission

Vertical transmission (transplacental, perinatal, breast-feeding) is a frequent route for HIV transmission to children.
Without interventions, 15% of infants born to HIV-positive mothers may become infected.
Risk factors include advanced maternal HIV stage, high maternal viral load and prolonged/premature rupture of membranes.
Breastfeeding doubles the risk of vertical transmission in the pre-ART era, but ART strongly reduces this risk.
In high-income countries, interventions like antenatal screening, ARV use and avoiding breastfeeding have significantly lowered vertical transmission rates.

HIV in High-Income Countries

Although new diagnoses are declining in high-income countries, HIV prevalence is rising.
In the UK, 101,600 people were estimated to live with HIV in 2017; 92% were diagnosed, and 98% of those diagnosed were on treatment, 97% of whom were virally suppressed.
Late diagnosis (CD4 count <350 cells/mL within 3 months of diagnosis) remains high in the UK, at 43% in 2017, down from 52% in 2004.
Continued high diagnostic and treatment accessibility is critical in high prevalence areas to reduce late diagnosis.

Other STIs

Other STIs, such as syphilis, gonorrhea, and Chlamydia, can increase the likelihood of HIV transmission.
Ulcerative STIs and HIV transmission are directly correlated.
Testing for other STIs and HIV should be part of the initial diagnosis for genital ulcers.

Pediculosis Pubis

Pubic lice (Phthirus pubis) attach to pubic hair, body hair, eyelashes, and eyebrows, typically from physical contact.
The primary symptom is itching due to hypersensitivity to louse bites.
Diagnosis involves visual inspection and observation of nits.
Treatment includes topical application of permethrin (10 mins) or malathion (12 hours), with a second application after 7 days. Precaution must be taken on pregnant women.

Donovanosis

Donovanosis (granuloma inguinale) is rare, predominantly in South-East Asia.
It is caused by Klebsiella granulomatis.
Friable ulcers or hypertrophic lesions develop at the inoculation site, with inguinal lymph node enlargement possible.
Diagnosis is based on identifying Donovan bodies (encapsulated Gram-negative bacteria) in scrapings or biopsies.
The treatment consists of antibiotics given until ulcer healing.

Scabies

This topic is discussed on page 674 of the document.

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Description

Test your knowledge about the treatment duration for various infestations and sexually transmitted infections. This quiz covers permethrin and malathion application durations, as well as recommendations for pubic lice and Donovanosis treatments. Enhance your understanding of effective methods for managing these conditions.