Background

• Infections of the human genito-urinary and reproductive systems transmitted via human sexual contact (sexually transmitted disease, STIs). The most common causes of male urethral discharge are a) the gonococcus Neisseria gonorrhoea and b) Chlamydia trachomatis. The most common causes of male and female genital ulcer are c) syphilis (Treponema pallidum), d) herpes simplex virus (HSV1 or 2) and e) chancroid (Haemophilus ducreyi).
• STIs are endemic in most countries of the world, including countries in Africa. Multiple simultaneous STIs are common (for example, gonorrhoea plus Chlamydia). STIs may be most highly prevalent in areas where HIV occurs and may facilitate HIV transmission. STIs may be primary or from repeated attacks of urethral discharge.
• STIs are a leading cause of abortion and stillbirth, prematurity, and congenital infections. They may lead to pelvic inflammatory disease (PID), a major cause of decreased fertility.
• Incubation periods for gonorrhoea are 2 to 7 days; Chlamydia 7 to 14 days (or longer); syphilis, 10 days to 12 weeks (usually around 3 weeks), and chancroid, 3 to 14 days.
• STIs may be more commonly in men, in whom clinical evidence of infection may be more readily apparent.