Syphilis Screening and Treatment Integration †MyAssignmenthelp.com

Question: Discuss about the Syphilis Screening and Treatment Integration. Answer: Introduction: Syphilis is a venereal disease caused by Treponema pallidum. It is an infectious disease that is transmitted through sexual contact with infectious lesions (Chow et al, 2017). It can be transmitted from the mother to the fetus in the uterus, through blood transfusion and through contact of a broken skin with an infectious lesion. The first sign of the infection is appearance of a small, painless sore on the sexual organs, the rectum or in the mouth. This sore is commonly known as a chancre (Uslu et al, 2017). Syphilis is classified in 4 stages if not treated. The first two stages are considered to be the most infectious stages. They include the primary stage, the secondary stage, the latent stage and the tertiary stage. T. pallidum penetrates the mucous membrane in acquired syphilis and enters the lymphatics and becomes a systemic infection. The average incubation period from the time of exposure to development of lesions is 3 weeks. The primary stage involves the development of painless chancre after incubation at the site of transmission commonly on the external genitalia (Tuddenham Ghanem, 2015). This stage occurs between the third and the fourth week of infection by the bacteria. The secondary stage occurs 4-10 weeks after the primary stage. The spirochetes spread throughout the body with variable manifestations of the lesions. When systemic, the manifestations include fever, malaise, lymphadenopathy, rash, weight loss, hair loss, and aching joints (Taylor et al, 2017). Histologically, the reaction from the inflammation is similar to the primary chancre but less intense. These symptoms usually go away with or without treatment though the treatment will still be present without treatment. Another stage is the latent syphilis where the secondary features have resolved. The infectious skin lesions recur from the secondary stage (Handsfield, 2015). If untreated, the latent syphilis develops to tertiary syphilis after many years of infection. The final stage is tertiary syphilis which when it occurs, it affects the cardiovascular and the central nervous systems damaging the tissues. This stage can be life threatening and can cause outcomes such as blindness, mental illness, memory loss, destruction of soft tissue and bone, deafness, neurological disorders such as meningitis, heart disease and neuro-syphilis (Kenyon et al, 2017). Congenital syphilis occurs when the treponemes cross the placenta and infect the fetus which causes spontaneous abortion and stillbirth. Assessment and Management of Syphilis Syphilis, in most cases, poses a challenge in its diagnosis as one may be infected and show no symptoms for quite some time, even years. Blood and urine samples are collected to run tests and also a thorough physical examination is conducted (Navale et al, 2014). Syphilis diagnosis is mostly done by dark-field microscopy when an active chancre is present. The lesion is cleansed and abraded with a gauze pad. On appearance of serous exudates, it is placed on a glass slide and examined under a microscope with a dark-field condenser. The spirochete is characterized by a corkscrew appearance. For a lesion for T.pallidum to be considered negative, negative examinations are necessary on three different days (Klausner, 2017). The screening of syphilis widely uses qualitative nontreponemal tests. Their usefulness is however limited by decreased sensitivity of primary stages of syphilis and the latent stage. Nontreponemal tests become nonreactive after proper treatment of syphilis. Treponemal- specific tests are also used to detect antibodies produced on the onset of T. pallidum antigens. This test is used on patients whose nontreponemal test is reactive. The center for disease and prevention (CDC) recommends penicillin G that is parenterally administered for all stages of syphilis. A single intramuscular injection of Benzathine penicillin G of 2.4 million is ministered to cure syphilis (Klausner, 2017). Treatment by penicillin kills the bacteria but does not repair the damage done on the skin. Doxycycline is considered is one the best alternatives in treating early and latent syphilis (Lithgow et al, 2017). Patients under treatment should abstain from sexual contacts until the sores are fully healed. In any stage of treatment of syphilis, acquiring other STIs should be taken into account. In the initial evaluation, HIV testing is necessary for all syphilitic patients (Mller, 2011). Screening for other diseases like hepatitis B and C, chlamydial infection and gonorrhea should also be considered. After administration of proper treatment, follow up with quantitative nontreponemal test titers in order to establish treatment response. Whe n syphilis remains untreated it can cause damage to important organs in the body like the heart and the brain thus the need for early treatment. Ethical and legal issues with regard to STIs have been raised by therapists. The first issue raised is patient safety which requires that a patient must be thoroughly examined before prescribing medication to ensure that the right infection is being treated and to avoid any allergic reactions (Lago, 2016). Examination also allows the patient to inquire more about the infection, treatment and also present relevant medical history. Secondly, informed consent is mandatory. The patient has the right to get information on the symptoms, complications, disbursement of treatment and the risks that come with the treatment so that he/she is able to make informed decisions concerning the management of the disease (Klausner, 2017). Another important aspect is the need for confidentiality. In this regard, information on a patients condition should be kept private and confidential and only revealed with the consent of the patient and can only be breached when the infection is of public health concern (Lithgow et al, 2017). Therefore, confidentiality of a patients health de tails is protected by the law because disclosure can cause harm to the patient. Lastly is equity which requires that health care resources be distributed according to peoples difference in need, worth and ability to pay. Laws have been made to ensure there is no discrimination based on ones health status. For example, discriminating one in employment based on his/her health status. Role of Sexual Health Teams To effectively manage syphilis interventions, a multidisciplinary care team is recommended. The sexual health team would include nurses, pharmacists and doctors with behavioral skills. They play the various roles in the management of Syphilis (Lago, 2016). The first role of the team includes patient based care. This involves planning and delivering care to the patient. It starts with protocols that define the assessment and treatment that are of quality care. The required steps for the delivery of the interventions are delegated to the team members according to their specified duties (Klausner, 2017). The treatment plan should come second. The treatment team knows and should provide the most preferred treatment required by the patient with regard to the disease and the medical history of the patient. Thirdly there is need for clinical management. This would be best done by nurses who would monitor the progress of the patient as he takes on the treatment. They should be able to monitor any effect of the treatment on the patient. Another role performed is to provide self management support. Educational interventions often support patients to change risky behaviors or help them became better self-managers (Handsfield, H. (2015). This helps reduce the risk of re-infection and possible transmission to others. It is therefore advantageous to have a nurse trained on behavioral counseling since most doctors neither have the skills nor the time to do counseling on behavior change. Lastly, there is need for sustained follow up. Close follow up is necessary in the management of syphilis so as to monitor problems in compliance, inability to respond to treatment, detect adverse effects of the treatment (Mller, 2011). Telephone follow up is commonly done by nurses. Therefore, to manage syphili s, various groups have to work together as a team to merge the different skills such as counseling, pharmacology, diagnostic skills and patient care. Education needs to prevent further STIs The education needs for individuals at risk of contracting or those already with the condition are based on the basis that the STI is a very contagious disease which spreads majorly through sexual activities. Thus one of the needs includes information on the pathophysiology and how the disease is transmitted from an infected person to another. From research, it is spread from sores and lesions on the skin of infected person to another when they come in contact during unprotected sexual intercourse (Callander et al, 2013). Secondly, there is need for education on the symptoms and signs of the condition for people to seek early medical attention. There is need to however emphasize that a lot of infected persons are always not aware of being infected and therefore, they easily unknowingly pass the infection to their sexual partners. Thirdly, educational approaches should focus on prevention measures against syphilis. Among them is that the STI can be prevented majorly through self care. This helps in lowering the chances of getting infected or re-infected with not just syphilis but other sexually transmitted infections. Practicing safe sex is one of the ways of preventing syphilis (Ahmed-Jushuf, 2010). Limiting oneself to one sexual partner and ensuring that your partner does not get involved in risky sexual behaviors. Another preventive measure is the use of condoms during sexual intercourse (Handsfield, 2015). Condoms reduce the risk of contracting STIs but only if it covers the lesions and sores. Educational and coaching approach should also focus on emphasizing the need to avoid drug abuse. Abuse of alcohol and other hard drugs may cloud ones judgment which may lead one to unsafe sexual practices (Taylor et al, 2017). Abstinence from sex as a preventive measure should be emphasized as an educational need, since it is considered to be the surest ways of avoiding any STIs. Syphilis has no vaccine and is transmitted through sexual contact with an infected person. It is also important to regularly get tested for STIs as a way of keeping oneself healthy. A further important educational need includes the diagnosis, management and treatment of syphilis. Individuals should be taught on these particular issues to ensure that they seek medical attention early enough before the progression of the disease gets worse. According to Ahmed-Jushuf (2010), health promotion to individuals at the risk of contracting such STIs as syphilis should focus on addressing poor health-seeking behavior so as to enlighten the community on the need for attention to healthcare. References Ahmed-Jushuf, I. (2010). Standards for the Management of Sexually Transmitted Infections.Sexually Transmitted Infections,86(3), 160-160. Callander, D., Baker, D., Chen, M., Guy, R. (2013). 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