Acknowledgements

Bacterial vaginosis

Bacterial vaginosis, previously known as nonspecific vaginitis or Gardnerella vaginitis, is the most common cause of vaginal discharge. This clinical syndrome is now recognised as a polymicrobial superficial vaginal infection involving a loss of the normal lactobacilli and an overgrowth of anaerobes. While commonly found in increased numbers in women with bacterial vaginosis, G. vaginalis is not invariably present. G. vaginalis has been reported in 16 to 42 percent of women with no signs or symptoms of vaginitis.

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  Clinically confirmed: At least three of these criteria must be present for diagnosis
  
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    Homogeneous vaginal discharge (colour and amount may vary)
    
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    Presence of clue cells (greater than 20%)
    
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    Amine (fishy) odour when potassium hydroxide solution is added to vaginal secretions (commonly called the "whiff test")
    
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    Vaginal pH greater than 4.5
    
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    Absence of the normal vaginal lactobacilli.
    

Genital Ulcer Syndrome

This clinical syndrome is an indicator of sexually transmitted infection.

confirmed case

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  Clinically confirmed: Any male or female with ulcers or vesicles present in the anogenital region: scrotum, penis, vulva, vagina, cervix, perianal area, or inner thighs with or without regional lymphadenopathy.
  

Lymohogranuloma Venereum

Infection with L1, L2, or L3 serovars of Chlamydia trachomatis is sexually transmitted and may result in a Genital Ulcer Syndrome.

Confirmed case

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  Laboratory confirmed: a case of Genital Ulcer Syndrome (see case definition) with isolation of C. trachomatis, serotype L1, L2, or L3 from a clinical specimen by cell culture or direct antigen, PCR or LCR methods from a genital ulcer.
  

Ophtalmia Neonatorum

This clinical syndrome without specific aetiological laboratory diagnosis may be an indicator of sexually transmitted infections among childbearing females.

confirmed case

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  Clinically confirmed: Any infant with acute redness and swelling of conjunctiva of one or both eyes, with purulent discharge in the first month of life following vaginal delivery.
  

Urethral Discharge (Genital Discharge Syndrome)

This clinical syndrome is an indicator of sexually transmitted infection.

confirmed case

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  Clinically confirmed: Any male with urethral discharge that is cloudy or opaque, viscous or sticky, appearing at the urethral meatus spontaneously or after milking the urethra.
  

Vaginal discharge (Genital Discharge Syndrome)

This clinical syndrome is an indicator of sexually transmitted infection.

confirmed case

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  Clinically confirmed: Any female with mucopurulent (yellowish), exudative endocervical discharge present on speculum examination.
  

Definitions of STI, by Aetiology

Chancroid

Infection with Haemophilus ducreyi is sexually transmitted and may result clinically in a Genital Ulcer Syndrome.

Confirmed case

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  Laboratory confirmed case: A case of Genital Ulcer Syndrome (see case definition) with isolation of H. ducreyi from a clinical specimen by culture, antigen detection or DNA amplification.
  

Chlamydial Infections

Infections caused by Chlamydia trachomatis can be sexually transmitted and may result in urethritis, epididymitis, cervicitis, acute salpingitis (pelvic inflammatory disease), proctitis, or other syndromes (see Lymphogranuloma Venereum). Infection may be asymptomatic.

Confirmed case

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  Laboratory confirmed: Detection of C. trachomatis by cell culture, direct antigen, PCR or LCR methods from an intraurethral (male) or endocervical swab (female).
  

Chlamydial Infections (Neonatal)

Perinatal infections with Chlamydia trachomatis may result in Ophthalmia neonatorum, and acute inflammatory condition of the conjunctiva among newborns. It could also result in acute pneumonia among newborns and infants.

Confirmed case

Laboratory confirmed: a case of O. neonatorum (see case definition) with detection of C. trachomatis by cell culture or direct antigen method from conjunctival exudate or pseudomembrane.

Gonococcal Infection (Neonatal)

Perinatal infection with Neisseria gonorrhoeae may result in Opthalmia neonatorum, an acute inflammatory condition of the conjunctiva among newborns.

Confirmed case

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  Laboratory confirmed: A case of O. neonaturum (see case definition) with isolation of N. gonnorhoeae from an eye swab.
  

Herpes Simplex Virus Infections (Genital)

Infection with herpes simplex virus (HSV) types 1 or 2 may be sexually transmitted and may result in recurrent episodes of a Genital Ulcer Syndrome. Because of its chronic evolvement, only an initial episode of genital herpes should be reported.

probable case

A Genital Ulcer Syndrome (see case definition) with clear vesicles on an erythematous base in the anogenital area and no previous documentation of such an occurrence.

Confirmed case

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  Laboratory confirmed: A probable case with isolation of HSV1 or HSV2 from clinical specimen by culture or DNA detection by multiplex PCR.
  

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