2024 SHELC STIs.ppt.pdf

Sexually Transmitted Infections / Diseases (STIs/STDs) Infections spread from person to person primarily through sexual contact and lead to diseases and/or clusters of diseases that may be crippling, fatal or deadly. Sexually Transmitted Infections More than 25 sexually transmit...

Sexually Transmitted Infections / Diseases (STIs/STDs) Infections spread from person to person primarily through sexual contact and lead to diseases and/or clusters of diseases that may be crippling, fatal or deadly. Sexually Transmitted Infections More than 25 sexually transmitted infectious organisms can be passed from person to person through sexual activities Bacterial STIs are often curable Viral STIs are not curable A Silent Epidemic Epidemics – occurrences of diseases in which many people in the same place at the same time are affected Why are they spreading so quickly? ◦ Many STDs are asymptomatic – showing no signs/symptoms  Don’t get treatment because they don’t know they’re infected ◦ Don’t like to talk about it ◦ People are scared or embarrassed to get tested STDs are a growing problem Rates of STI’s have steadily increased ◦ 1960’s = 2 STI’s of major concern – syphilis and gonorrhoea (both can be cured) ◦ Today = more than 25 STI’s 1 in 4 sexually active adolescents become infected before graduating high school How are STIs spread? ALL SEXUAL ACTIVITY ◦ Any type of sexual activity that brings an uninfected person in contact with body fluids from an infected person ◦ Any sexual activity that results in contact between one person’s genitals and another person’s skin or mucous membranes, in which one of the persons is already infected with an STI ◦ Direct contact with open sores A mother to her baby before birth, during birth, or during breast-feeding High-Risk Behaviors and STIs Being sexually active with more than one person. Infidelity of sexual relationships Engaging in unprotected sex Selecting high-risk partners Abuse of alcohol and other drugs Non-clinical tattooing Sharing shaving and incising blades Consequences of STDs Some STIs are incurable Can cause cancer Can cause complications that affect the ability to reproduce Some STIs can be passed from an infected female to her child before, during, or after birth SEXUALLY TRANSMITTED INFECTIONS Common Modes of transmission stis Keyword search for atlas of venereal and skin diseases https:// www.sciencephoto.com/keyword/atlas-of-venereal-a d-skin-diseases Check this website and get the shock of cruelty of uncreative STIs. Keyword search for atlas of venereal and skin diseases  HIV/AIDS and CD4 by MPHERWANE SK Department of Physiology and Environmental Health IMMUNE ORGANS IMMUNE CELLS Immune system…… MACROPHAGES- CELLS WHICH PHAGOCYTOSE  You are not expected to memorise their names just know they & many more of such are there in our systems.  “La Bantwana ba wrong; Ba yi faka eMakhaleni, Ba yi faka”…..Phagocytes  But the Phagocytes in our immune armed response are good & powerful.  We are fearfully and wonderfully made: Psalm 139:14   The baton, animating/mimicking the antigen of the pathogen. The man in blue, the CD-4 cell. After phagocytosis there is antigen presentation like in relay marathons  A virus is an infectious microbe consisting of a segment of nucleic acid (either DNA or RNA) surrounded by a protein coat.  A virus cannot replicate alone; instead, it must infect cells and use components of the host cell to make copies of itself.  Often, a virus ends up killing the host cell in the process, causing damage to the host organism.  Well-known examples of viruses causing human disease include HIV, COVID-19, measles and smallpox.  Virus (HIV) HIV Anatomy/morphology/structure HIV Anatomy/morphology/structure  Life Cycle of HIV Steps in Viral Replication 1. Attachment/Entry 2. Reverse Transcription & DNA Synthesis 3. Transport to Nucleus 4. Integration 5. Viral Transcription 6. Viral Protein Synthesis 7. Assembly of Virus 8. Release of Virus 9. Maturation STAGES OF INFECTION Graphical representation of HIV infection stages 1980s: Acronym from ACQUIRED IMMUNE DEFICIENCY SYNDROME A disease in which there is a severe loss of the body's cellular immunity, greatly lowering the resistance to infection and malignancy. Think of any infection/s: It/they is/are likely to be contracted by the individual whose body has succumbed to AIDS state. In this state AIDS Acquired immunodeficiency syndrome (AIDS) is defined in terms of either a CD4+ T cell count below 200 cells per µL or the occurrence of specific diseases in association with an HIV infection In the absence of specific treatment, around half of people infected with HIV develop AIDS within ten years. The most common initial conditions that alert to the presence of AIDS are pneumocystis pneumonia (40%), cachexia in the form of HIV wasting syndrome (20%) and esophageal candidiasis.] Other common signs include recurring respiratory tract infections. The worst complication being the Multi drug resistant Tuberculosis Where should we direct the Anti -retro-viral drugs? (ARVs)  Life Cycle of HIV Steps in Viral Replication 1. Attachment/Entry 2. Reverse Transcription & DNA Synthesis 3. Transport to Nucleus 4. Integration 5. Viral Transcription 6. Viral Protein Synthesis 7. Assembly of Virus 8. Release of Virus 9. Maturation OPPOTUNISTIC INFECTIONS Few ways on how we can be infected Few ways on how we can be infected HOW DO WE….? Blood vessel, blood cells and the Virus Outline Life Cycle of HIV Major Target Cells for HIV Cell surface receptors for HIV CD4 CD4- gp120 Interactions Theories of Immune System cell Loss in HIV infection Challenges Ahead A cell is said to be a CD-4 cell, if it has a CD-4 receptor protein sticking on its cell membrane. CD-4 T- Helper cell  ClusterDesignation 4  Expressed on T-helper lymphocytes ◦ signaling other cells in immune system ◦ healthy: 800~1200 CD4+ T cells/mm3 ◦ AIDS: < 200 CD4+ T cells/mm3  less densely on macrophages, dendritic cell* and microglial cells CD4 Few ways on how we can be infected   The baton, animating/mimicking the antigen of the pathogen. The man in blue, the CD-4 cell. After phagocytosis there is antigen presentation like in relay marathons Phagocytosis and handing over to the CD-4 helper cell T- cells/ CD-4 T- Helper cells activate other immune cells to engage in the battle against infection  Hell Hath No Fury Like that of A Woman Scorned. By Tyler Perry's  When a woman cries; Oh boy! They activate activity. They call for help from all over  When the T-Helper cell interacts with antigen infectious agent; Oh Boy! It activates other immune cells and Hell breaks loose in a quest to fight the enemy/infection Role of CD8+ T cells ◦ attack and killed infected cells ◦ secrete soluble factors that suppress HIV replication (e.g. RANTES, MIP-1alpha, MIP-1 beta) Challenges Ahead IMMUNODEFICIENCY VIRUS (HIV) HIV Anatomy/morphology/structur e HIV Anatomy/morphology/structur e HIV Infection Outline Life Cycle of HIV Major Target Cells for HIV Cell surface receptors for HIV CD4 CD4- gp120 Interactions Theories of Immune System cell Loss in HIV inf ection Challenges Ahead Hey you HIV! Watch your steps,. “What did you say wena, student /lecturer?” You too, man! Watch my steps. ”  Life Cycle of HIV Steps in Viral Replication 1. Attachment/Entry 2. Reverse Transcription & DNA Synthesis 3. Transport to Nucleus 4. Integration 5. Viral Transcription 6. Viral Protein Synthesis 7. Assembly of Virus 8. Release of Virus 9. Maturation Infection ◦ CD4+ T-Lymphocytes ◦ CD4+ monocytes and macrophages (inclu. microglia) ◦ CD4+ Dendritic cells (inclu. Langerhans cells) Major Target Cells for HIV Graphical presentation of the stages of HIV infection & Progression STAGES OF INFECTION Acronym from ACQUIRED IMMUNE DEFICIENCY SYNDROME A cluster of diseases resulting from severe loss of the body's cellular immunity, greatly lowering the resistance to infection and malignancy. Think of any infection/s: It/they, is/are likely to be contracted by the individual whose body has succumbed to AIDS state. AIDS Acquired immunodeficiency syndrome (AIDS) is defined in terms of either a CD4+ T cell count below 200 cells per µL or the occurrence of specific diseases in association with an HIV infection In the absence of specific treatment, around half of people infected with HIV develop AIDS within ten years. The most common initial conditions that alert to the presence of AIDS are pneumocystis pneumonia (40%), cachexia in the form of HIV wasting syndrome (20%) and esophageal candidiasis. ] Other common signs include recurring respiratory tract infections. The worst complication being the Multi drug resistant Tuberculosis OPPOTUNISTIC INFECTIONS Where should we direct the Anti -retro-viral drugs? (ARVs)   Blockinggp 120 binding to CD4  Secondary receptor for fusion (fusion cofactor/fusin) ◦ new target for anti-HIV drug (JM3100) ◦ not effective on macrophages infection Challenges Ahead Few ways on how we can be infected HERPES SIMPLEX 1: HERPES Cell Press Herpes Simplex Virus-1 in the Brain: The Dark Side of a Sneaky Infection: Trends in Microbiology Diagnosis and Treatment Diagnosis– Viral cultures As many as 90% do not know they are infected Treatment ◦ Anti-viral medications  Reduces the duration and intensity of symptoms Transmission of Herpes Skin to skin contact ◦ Kissing with a sore ◦ Touching a sore ◦ Sexual activity Exposure to infected body fluids During childbirth Long-term effects of Herpes NO CURE!!! Can transmit to others even at time when not experiencing symptoms 90% will experience at least one recurrence within 12 months of initial episode Recurrences can occur for the remainder of the person’s life Risk of spontaneous abortion and premature birth Principal Bacterial STIs Chlamydia ◦ Responsible for 80% of women’s tubal infertility ◦ Infects 2.8 million Americans each year Gonorrhea ◦ 700,000 Americans contract gonorrhea each year ◦ Can cause sterility in both men and women Syphilis ◦ Infection has stages that indicate progression of infection ◦ Can lead to brain damage and death in newborns Urinary tract infections ◦ Caused by several different bacteria Principal Viral STIs Human Papillomavirus (HPV) ◦ 20 million carriers, 5.5 million new cases yearly ◦ Treatment and vaccine Herpes Simplex Virus (HSV) ◦ 45 million Americans infected ◦ Managing symptoms Hepatitis A, B, C ◦ Viral disease of liver ◦ One third of Americans show evidence of past infection OTHER Sexually Transmitted INFECTIONS Bacterial vaginosis ◦ Caused by overabundance of Gardnerella bacteria ◦ Treat with antibiotics Candidiasis: Yeast Infections ◦ Many factors contribute to infection ◦ Men and women can carry the organism Trichomoniasis caused by protozoans ◦ Most common curable STI in young women ◦ Men and women can carry the organism Trichomoniasis: An Endoparasite Caused by a Protozoan Most common curable STI in young, sexually active women with recurrences yearly Increases the risk of contracting HIV Transmission ◦ Sexual contact Symptoms of Trichomoniasis 50-80% of women and some men do not know they are infected Women ◦ Vaginitis and/or Cervicitis  Vaginal discharge  Abnormal vaginal bleeding  Cervical irritation  Swelling and irritation of the genitals  Itching of the vulva  Abdominal pain Men ◦ Urethritis  Discharge from penis  Burning during urination  Ectoparasites: Lice and Scabies Parasites Pubic lice: Phthirus pubis; commonly known as crabs Scabies: mite Sarcoptes scabiei Both can also be transmitted non-sexually via clothes, towels, bedding or by contact even if is not sexual ECTOPARASITE Lice in pubic area Female Crab Louse Scabies mite ECTOPARASITES: SCABIES Scabies Scabies Scabies causing eczema-like hand condition STIs and Women Women’s anatomy increases susceptibility Pelvic inflammatory disease - PID ◦ Infection of fallopian tubes spreads ◦ One of the leading causes of female infertility ◦ Caused by some types of STI bacteria Cystitis: bladder infection ◦ Often related to sexual activity; not an STI ◦ Can create pain and damage kidneys STIs caused by Bacteria Chlamydia, Gonorrhoea, Syphilis, Bacterial vaginosis Chlamydia Most common Bacterial STI Transmitted ◦Through sexual activity ◦During childbirth Symptoms of Chlamydia 85% of women and 40% of men have no symptoms Vaginal or urethral discharge Burning with urination Pelvic Pain (women) Swelling and tenderness of the scrotum (men) Genital ulcers Long-term effects of Chlamydia Pelvic Inflammatory Disease (PID) ◦ Can damage the fallopian tubes and result in tubal scarring and infertility  Causes 25% of the infertility in women pursuing in vitro fertilization in the US ◦ Symptoms  Pelvic and abdominal pain  Fever  Abnormal vaginal bleeding  Ectopic (tubal) pregnancy Infants ◦ Illness ◦ Blindness Long-term effects of Chlamydia Diagnosis and Treatment Diagnosis – Lab Tests (genital fluids or urine) Treated easily IF caught early Treatment ◦ Oral antibiotics ◦ Newborn infants routinely receive antibiotic eye drops/ointment to prevent eye infection GONORRHOEA Symptoms of Gonorrhoea No symptoms in 25-80% of women and a smaller percentage of men. If and/or when symptom appear: Discharge from vagina or urethra Pain during urination Abnormal vaginal bleeding (“spotting”) – women Pain and swelling around the testicles – men Long-term effects of Gonorrhoea PelvicInflammatory Disease Pregnant women ◦ Spontaneous abortion ◦ Premature rupture of membranes ◦ Preterm birth ◦ May infect amniotic fluid  Blindness  Joint infection  Life-threatening blood infections Diagnosis and Treatment Diagnosis – Body fluids will be examined and tested Treatment ◦ Oral or injectable antibiotics ◦ After treatment, infected individuals should be re-examined and tested again SYPHILIS Called “The Great Imitator” ◦ Many of the signs/symptoms resemble other diseases Transmitted ◦ Sexual activity ◦ Contact with syphilitic sores ◦ Passed to infants during childbirth Symptoms of Syphilis Primary Stage (10-90 days after infection) ◦ Single sore (chancre)  Firm, round and painless  Occurs at spot where Syphilis entered body  Heals in 3-6 weeks if left untreated Secondary Stage (2-8 weeks after infection) ◦ Itch-less rash ◦ Flu-like symptoms  Fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches and fatigue Syphilis Symptoms (cont) Latent stage (2 or more years after) ◦ Signs disappear and think cured ◦ Attacks heart, blood vessels, and CNS Late stage (10 to 30 years after) ◦ Heart, skin, brain, spinal cord affected ◦ Cannot be cured at this stage  Secondary syphilis- rash CONGENITAL SYPHILIS on palms of hands Diagnosis and Treatment Diagnosis– blood test Treatment ◦ Can be cured if caught early ◦ Antibiotic  Will not repair or reverse the damage already caused by the disease  A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. STI’s caused by Viruses The 4 “H” common of viral STIs HPV, Genital herpes, Hepatitis, HIV CANNOT BE CURED!!! Human Papillomavirus Infections (HPV) Most patients have no symptoms Some develop Genital and Anal Warts Long-term effects of HPV: Cervical Cancer – Women Genital Cancers – Men and much more PRE-OPERATIVELY ON PRE AND POST SURGICAL (Tree man) OPERATION Diagnosis and Treatment Diagnosis ◦ abnormalities detected on a Pap Smear – women ◦ Most asymptomatic men do not know they are infected Treatment ◦ Topical medications applied to the wart  Decrease in size and disappear ◦ Surgical removal (burning with a laser) ◦ Freezing Even with treatment, warts will often return  Genital Herpes Most common sexually transmitted viral infection world wide ◦ Most cases of genital herpes are HSV-2  HSV-1 can be transmitted to genitals via oral sex Greatest risk factor is the total number sexual partners a person has had in their life Symptoms of Herpes Initial infection ◦ Fever, headache and muscle aches ◦ Lesions appear in area of exposure  Blisters which break and become ulcers  About 8 days after exposure  Painful and often burn or itch Other symptoms ◦ Burning with urination, vaginal or urethral discharge, tender swollen lymph nodes Recurrent outbreaks ◦ Skin lesions HERPES SIMPLEX 1: AVOIDING STIs Practice abstinence Avoid multiple partners Practice sexual Avoid injecting drugs exclusivity Get vaccinated Reduce risk during Protect babies sexual activity Be a good Select partners communicator carefully Avoid secretes, where you can Treating STIs & Being responsible about STIs Get tested for STIs Recognize STI symptoms Get partners to treatment Seek medical help right away Complete the full course of medications Have follow up testing done Avoid all sexual activity while being treated Notify ALL sexual partners Who Is Affected by STIs: Disparities Among Groups Gender disparities? Age disparities? Racial and ethnic disparities? Behavioral Factors Contributing to STI Transmission Early initiation of intimate sexual activity Numerous sex partners High-risk sex partners High risk sexual behavior Inconsistent and incorrect condom use Substance abuse Sexual coercion Lack of knowledge of and concern about STIs Consequences of STIs Women, men, and infants affected Presence of STIs increases HIV risk Untreated STIs have serious consequences ◦ Infertility/ sterility  Untreated Pelvic Inflammatory Disease (PID) causes 45% of women’s infertility  Ectopic pregnancy, miscarriage ◦ Blindness ◦ Cancer, heart disease Social Factors contributing to STI transmission Poverty and marginalization In accessibility to health care Secrecy and moral conflict about sexuality BIOLOGICAL FACTORS CONTRIBUTINGTO STI TRANSMISSION Asymptomatic nature Resistance to treatment or lack of a cure Other: douching, immature cervix, uncircumcised penis Other STIs Chancroid Cytomegalovirus Entericinfections Granuloma inguinale Lymphogranuloma venereum Molluscum contagiosum Summary STIs are epidemic STIs are linked to behavior Principal STIs STIs and women Preventing STIs Premature rupture of membranes Preterm labor Sexually Transmitted Infection Bacterial STIs are often curable Viral STIs are not curable