The Thai 2022 Sexually Transmitted Infections Treatment Guideline: Abnormal vaginal discharge

Main Article Content

Chenchit Chayachinda
Kittipoom Chinhiran
Rossaphorn Kittiyaowamarn
Surasith Chaithongwongwatthana
Nipat Teeratakulpisarn

Abstract

Abnormal vaginal discharge is one of the most common presenting symptoms at gynecologic clinics. Sexually transmitted infection (STI) is a subset of all etiologies; but appears to be a major public health concern as it much affects health and economy of the infected people. Improper or delayed management results in greater morbidity and mortality. From the epidemiological surveillance data in Thailand, STI is on the rise; and gonorrhea and chlamydial cervicitis appear to be the main STI causes of abnormal vaginal discharge. In this year, the Division of Autoimmune Deficiency Syndrome (AIDS) and Sexually Transmitted Infections (STIs), Thai Ministry of Public Health, in collaboration with Institute of HIV Research and Innovation (IHRI), Institute of Dermatology, Faculty of Medicine, Chulalongkorn University, and Faculty of Medicine Siriraj Hospital, Mahidol University, has issued the Thai national guideline for diagnosis and treatment of sexually transmitted infections, 2022. As a high proportion of women presenting with abnormal vaginal discharge are non-STI cases, the treatment guideline includes both STI and non-STI causes. And, this article will focus on only the section of the guideline for managing women with abnormal vaginal discharge.

Downloads

Download data is not yet available.

Article Details

Section
Special Article

References

World Health Organization. Sexually transmitted infections (STIs) 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis).

HIV INFO HUB. Rate of five main STIs reported case in Thailand, 2009-2020 2021 [Available from: https://hivhub.ddc.moph.go.th/epidemic.php.

Amabebe E, Anumba DOC. The Vaginal Microenvironment: The physiologic role of Lactobacilli. Front Med (Lausanne) 2018;5:181.

Woelber L, Prieske K, Mendling W, Schmalfeldt B, Tietz H, Jaeger A. Vulvar pruritus-—causes, diagnosis and therapeutic approach. Dtsch Arztebl Int 2020;117:126-33.

Workowski K, Bachmann L, Chan P, Johnston C, Muzny C, Park I, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021;70:1-187.

Marrazzo J, Handsfield H, Whittington W. Predicting chlamydial and gonococcal cervical infection: implications for management of cervicitis. Obstetrics & Gynecology 2002;100:579-84.

Thinkhamrop J, Lumbiganon P, Thongkrajai P, Chongsomchai C, Pakarasang M. Vaginal fluid pH as a screening test for vaginitis. Int J Gynaecol Obstet 1999;66:143-8.

Chayachinda C, Thamkhantho M, Chalermchockcharoenkit M, Nuengton C, Thipmontree W. Characteristics of clients at the Siriraj Female STD Clinic during 2011-2015. Siriraj Medical Bulletin 2018;11:182-9.

Sobel JD. Vulvovaginal candidosis. Lancet 2007;369: 1961-71.

Chayachinda C, Thamkhantho M, Ngamsakulrungroj P, Leeyaphan C, Tulyaprawat O. Effect of intravaginal gentian violet for acute vaginal candidiasis treated with a single dose oral fluconazole: a randomised controlled trial. J Obstet Gynaecol 2022.

Saxon C, Edwards A, Rautemaa-Richardson R, Owen C, Nathan B, Palmer B, et al. British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis (2019). International Journal of STD & AIDS 2020;31:1124-44.

Chayachinda C. A double-blinded, randomized controlled trial: comparison of the effectiveness of two single-dose vaginal tablets, sertaconazole vs clotrimazole, for treating vaginal candidiasis 2019.

Thamkhantho M, Chayachinda C. Vaginal tablets of dequalinium chloride 10 mg versus clotrimazole100 mg for vaginal candidiasis: a doubleblind, randomized study. Arch Gynecol Obstet 2021;303:151-60.

Amsel R, Totten P, Spiegel C, Chen K, Eschenbach D, Holmes K. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J med 1983;74:14-22.

Chayachinda C, Baukaew L, Thamkhantho M, Bangpichet A, Sodsee S, Pharkjaksu S. Clue cells as a single diagnostic method for diagnosing bacterial vaginosis during pregnancy. J Med Assoc Thai 2020;103:353-8.

Kingston M, Bansal D, EM C. 'Shelf life' of Trichomonas vaginalis. Int J STD AIDs 2003;14:28-9.

Rodrangnok W, Chayachinda C, Kittiyaowamarn R. Guideline and Management: Trichomoniasis. Siriraj Medical Bulletin 2021;14:64-9.

Kaambo E, Africa C, Chambuso R, Passmore J. Vaginal microbiomes associated with aerobic vaginitis and bacterial vaginosis. Front Public Health 2018;6:78.

Donders G, Ruban K, Bellen G. Selecting Anti-Microbial Treatment of Aerobic Vaginitis. Curr Infect Dis Rep 2015;17.

Donders GG. Definition and classification of abnormal vaginal flora. Best Pract Res Clin Obstet Gynaecol 2007;21:355-73.

Suresh A, Rajesh A, Bhat R, Rai Y. Cytolytic vaginosis: A review. Indian J Sex Transm Dis & AIDS 2009;30.

Fifer H, Saunders J, Soni S, Sadiq T, FitzGerald M. 2018 UK national guideline for the management of infection with Neisseria gonorrhoeae. Int J STD AIDS 2020;31: 4-15.

Horner P, Blee K, O'Mahony C, Muir P, Evans C, Radcliffe K. 2015 UK National Guideline on the management of non-gonococcal urethritis. Int J STD AIDS 2016;27: 85-96.

Sherrard J, Wilson J, Donders G, Mendling W, Jensen J. 2018 European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int J STD AIDS 2018;29:1258-72.

Soni S, Horner P, Rayment M, Pinto-Sander N, Naous N, Parkhouse A, et al. British Association for Sexual Health and HIV national guideline for the management of infection with Mycoplasma genitalium (2018). Int J STD AIDS 2019;30:938-50.