Reproductive Tract Infections: Global Impact and Priorities for Women’s Reproductive HealthAdrienne Germain, King K. Holmes, Peter Piot, Judith Wasserheit Reproductive tract infections (RTis) have become a silent epidemic that is devastating women's lives. Each year, thousands of women die needlessly from the consequences of these infections, including cervical cancer, ectopic pregnancy, acute and chronic infections of the uterus and the fallopian tubes, and puerperal infections. For many women, this happens because they receive medical attention too late, if at all. The terrible irony of this tragedy is that early diagnosis of and treatment for many RTis do not require high-technology health care. For the hundreds of millions of women with chronic RTis acquired from their sexual partners, life can become a living hell. Infection is a major cause of infertility, and it leads to scorn and rejection in many countries. These women may experience constant pain, have festering lesions of the genital tract, be at enhanced risk of second ary diseases, and endure social ostracism. The problems associated with RT!s have grown even greater in the past decade with the emergence of human immunodeficiency virus (HIV) and AIDS. Preexisting sexually transmitted disease, particularly when associated with genital tract ulcers, raises women's vulnerability to the transmission of HIV 3-5 fold. |
Contents
2 | |
Current and Future | 30 |
Importance of Reproductive | 61 |
The Responsibility to Prevent | 78 |
Both Pregnancy and Reproductive Tract Infections | 93 |
Opportunities | 145 |
Sexual Behavior as a Risk Factor | 185 |
Assessment and Prioritization of Actions | 199 |
Economic Impact of Reproductive Tract | 227 |
The Need | 317 |
Recommendations for Action | 363 |
List of Authors and Participants | 373 |
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Common terms and phrases
abortion adverse outcome Africa AIDS antenatal associated asymptomatic bacterial vaginosis birth cervical cancer chancroid Chlamydia trachomatis chlamydial infection commercial sex condoms contraceptive control programs cost cost-effective CSWs delivery developing countries developing world diagnosis ectopic pregnancy effective epidemiology family planning clinics female genital tract genital ulcer gonococcal infection gonorrhea groups HIV infection HIV transmission Holmes KK hospital human immunodeficiency virus Ibadan impact implement incidence increased infants infertility interventions Kenya male maternal morbidity mortality Nairobi Neisseria gonorrhoeae neonatal Nigeria Obstet Gynecol patients pelvic inflammatory disease percent perinatal Piot population postpartum pregnant women prevention and control Priority reproductive health Reproductive Tract Infections risk factors role RTIs screening sepsis sequelae sex partners sexual behavior sexual partners sexually active sexually transmitted diseases social STD clinic STD control strategies syphilis Table Third World treatment tubal urethritis vaginal Wasserheit JN women's health