Activity 5: Sexually Transmitted Infections/ Reproductive Tract Infections (STI/RTI)

IHP has funded the following STI/RTI related activities of ICDDR,B.

Surveillance for antimicrobial resistance in STI, especially N. gonorrhoea:

PI: Dr. Dipak Kumar Mitra

There is a body of evidences that shows STI infected population has increased chances of acquisition and transmission of HIV. N. gonorrehoea is one of such STI bacteria that quickly become resistant to drugs. Since 1997, ICDDR,B has been carrying out surveillances in our Mirpur field site in Dhaka city to monitor the antimicrobial resistance pattern. In the beginning the resistance to ciprofloxacin, the drug of choice, was only 3%, but has increased gradually to over 95% in 2005.

Our surveillance on antimicrobial resistance monitoring helped us to identify the development of antimicrobial resistance pattern and contributed in the application of right antimicrobial agent against N. gonorrhoea. The results of our studies are regularly published in ICDDR,B’s Health Science Bulletin (HSB) and in other health related journals. The findings have already been incorporated in the updated National Guidelines for Management of Sexually Transmitted Infections.

Collaborating Institutions:

• Institute of Epidemiology, Disease Control and Research (IEDCR) of Directorate General of Health Services

Results:

• Antimicrobial resistance monitoring has identified resistant drug (Ciprofloxacin) against N. gonorrhoea and it is now helped us to modified the treatment regime accordingly.

Epidemiology of Human Papillomavirus among Females in Bangladesh

PI: Dr. Dipak Kumar Mitra

Cervical cancer is the second most frequent cancer among women globally. This particular cancer is caused by Human Papillomavirus (HPV). Previously we, in Bangladesh, did not have much data on the prevalence of this virus/cervical cancer. ICDDR,B in collaboration with Institute of Epidemiology, Disease Control and Research (IEDCR) of Directorate General of Health Services collected specimen from four Upazilla health complexes, Sarsha of Jessore, Shibgonj of Chapainababgonj, Bakergonj of Barisal and Golapgonj of Sylhet.

Preliminary results showed that prevalence of HPV infection among women is very high in Bangladesh. In addition, this study would allow us to identify the particular genotypes of HPV prevailing among women in Bangladesh. The study results can be used for designing a vaccine programme in future to combat against cervical cancer.

Collaborating Institutions:

• Institute of Epidemiology, Disease Control and Research (IEDCR) of Directorate General of Health Services

Results:

• In collaboration with IEDCR, the study has been implemented in different parts of the country. Currently the data analysis is ongoing.
• This study will generate data on prevalence of cancer associated HPV among female population in Bangladesh with its various genotypes.
• This information may be used for designing a vaccine program against cervical cancer in the country in future.

Updated National Guidelines for Management of Sexually Transmitted Infections:

PI: Dr. Dipak Kumar Mitra

ICDDR,B coordinated the efforts of National AIDS/STD Programme (NASP) and the Directorate General of Health to update the National Guidelines for Management of Sexually transmitted Infections that was approved by the technical committee of National AIDS Committee and the Ministry of Health and Family Welfare. The new edition includes the most recent management practice for treating sexually transmitted infections in perspective of Bangladesh. It is expected that the new guideline will have positive effect in control and prevention of STI and HIV in the country.

The English version of the national STI Management Guideline has already been published and was launched by the Honourable Advisor Major General Dr. ASM Matiur Rahman (Rtd) of Ministry of Health and Family Welfare on 27th February 2007. We distributed copies of the guideline to all the Upazilla health complexes, district hospitals and medical colleges with instruction from the National AIDS/STD Programme (NASP).

We have translated the English version of the guideline to Bangla. The Bangla version of the guideline will be especially useful for the paramedics.

Collaborating Institutions:

• National AIDS/STD Programme (NASP)

Results:

• Under the leadership of NASP, the STI management guideline has been updated with inputs from the experts in the country.
• The guideline provides effective STI management tools for service providers in Bangladesh.

Strengthening Laboratory Capacity of Surveillance System of IEDCR

PI: Dr. Md. Anowar Hossain

This activity has the goal to strengthen and standardize the laboratory capacity of surveillance system of IEDCR in Upazilla health complex resulting in effective management of common diseases in the rural community. The laboratory technicians are also trained.

The findings and experience could be scaled up in other health complexes in the country

Collaborating Institutions:

• Institute of Epidemiology, Disease Control and Research (IEDCR) of Directorate General of Health Services

Results:

• Continue working on strengthening laboratory capacity of surveillance system of IEDCR
• Supply necessary equipment and consumables