National Guidelines for Management of Sexually Transmitted Infections

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Preface

HIV and AIDS have become global problems. Many countries around the world are experiencing an epidemic of these sexually transmitted diseases. Bangladesh is still fortunate in avoiding an AIDS epidemic. Although Bangladesh is a low prevalence country, it is highly vulnerable to HIV/AIDS because of high-risk behaviours. Injecting drug use, commercial unprotected sex with overlaps between more vulnerable and bridging populations, and high rates of sexually transmitted infections (STIs) increase exposure. High-risk behaviour poses a greater threat for a future epidemic. As of December 2005, the reported number of HIV positive cases was 658 with an estimated number of 7,500 in Bangladesh.

Because of a synergistic relation of STI with HIV, global HIV/AIDS control programmes have focused attention on STI prevention and control to combat an HIV epidemic.. Common factors are associated with the transmission and spread of these diseases. The National AIDS/STD programme has been working to prevent HIV/AIDS in Bangladesh since 1989, also focusing on more effective STI management.

The National AIDS/STD programme has developed the current guidelines by involving representatives of DG-Health, DG-Family Planning, research organizations, programme implementers, development partners, management agencies and NGOs. This updated, comprehensive guideline for the management of STI has been developed using WHO, CDC and other regional guidelines. Besides emerging issues such as antimicrobial resistance (ineffective antibiotic use) to STI pathogens, these updated guidelines aim to accommodate issues identiﬁed through evidence-based research in Bangladesh. The following concerns have been addressed:

Guidelines for STI management for high risk populations
Guidelines for STI management for general populations
Over treatment of cervicitis among females from the general population
Under treatment of STIs among women with high risk behaviour
Appropriate drugs for treatment
Non-compliance of treatment
Treatment of subjects having no symptoms, based on risk of acquisition of infection.

This comprehensive national STI management guideline will help us to treat sexually transmitted infections successfully and thereby contain HIV epidemics in Bangladesh.

Prof. Dr. Md. Shahadat Hossain

Director General, DGHS &

Line Director, National AIDS/STD Programme

Directorate of Health Services

Ministry of Health & Family Welfare