Sexually Transmitted Infection (STI) Testing at Manila Genitourinary Clinic

STI Diagnosis and Treatment

The approach for diagnosis and treatment taken by most medical
practitioners either diagnostic and treatment guidelines recommended
by the American Center for Disease and Control (CDC) or from the
Word Health Organization (WHO). It is termed as the “Syndromic
Approach.” It is based on what the patients “feels and sees” and not
based on scientific process of Medical History, actual Physical
Examinations and Diagnostic evaluations.
The Syndromic approach led to the conversion of Silent Carriers
consequently led not only to a Silent Epidemic but also a poor quality of
reproductive future.

The Manila Protocol for the Diagnosis and Treatment for STI`s is to
utilize objective parameters taken from the use of reliable patient
profile, medical history, physical examination and the use of sensitive
and specific diagnostic workup. This minimizes the risk of recurrence
due to poor contact tracing and insufficient treatment. The results are
higher success rates, better quality of reproductive future which
everyone deserves.

Patient Profile
Determining age, gender, coitarche, marital status, patient reliability
(to mention a few) help assess risk factors, probable causative and
coexisting disease entities a patient might have all together.

Medical History
Make use of grading system such as symptom score, visible signs,
symptoms associated when it was first noticed in line with the time
frame of exposure/s. This helps in establishing incubation periods,
clinical course important in determining the most likely disease agent.

Physical Examination
This involves a visual and protected examination of lesions the patient
may have. The added information adds more depth in establishing what
a patient may have.

Diagnostic Aids
Are used only to confirm the physicians diagnosis and never use to
diagnose without a through patient evaluation otherwise misdiagnosis
through false positives, false negatives and laboratory error will
dominate the decision making process.

Diagnostic Aids come in different forms. There are screening and
Generally specific examinations.

Microscopic Examinations
Generally are useful for screening, easy to perform, results are readily
available for a quick and reasonable decision making. It is also useful in
monitoring patient respond to treatment.

Anti-Body Testing
These are useful as a screening tool for suspected infectious agents.
Results are faster as compared to confirmatory test. The downside for
this procedures are the false negatives and positives, consequently
under and over treatment cannot be avoided.

Cultures are considered specific test, however results take several days
and the sensitivity of these examinations are not as good as expected.

Molecular biology
Are most likely reliable in terms of specificity but not sensitive. Results
take time and require properly trained technicians and microbiologist.

"Medicine is a Science of Uncertainty and an Art Of Probabilities'"  William Osler

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