1- esckþIepþIm
CMgWkameraK manTMnak;TMngy:agCitsñiTCamYynwgkarrIkraldalénemeraKeGds_¼CMgWeGds_ . karqøgCMgWkameraKnaMeGayGñkEdlmanpÞúkemeraKeGds_gaynwgqøgCMgWepSg²eTot ehIyGñkEdlBMuman pÞúkemeraKeGds_k¾gaynwgqøgemeraKeGds_Edr. kñúgry³eBlCag 15qñaMknøgeTAenH karBinitürkeraK vinicä½y nig RbsiT§iPaBénkarBüa)alCMgWkameraK )anedIrtYnaTIy:agsMxan;kñúgkarbgáar nig Tb;sáat;kar qøgraldalénemeraKeGds_¼CmW¶eGds_ . elIsBIenHeTAeTot plb:HBal;énkarmin)anBüa)alCMgW kameraK GacbgáeGayeRKaHfñak;y:agF¶n;F¶r CaBiesscMeBaHRsþI. Ep¥kelIehtuplTaMgenH karRKb;RKg EfTaMBüa)alCMgWkameraK)anqab;rh½sTan;eBlevla nig manRbsiT§iPaB KW mansar³ sMxan;Nas; .
enAqñaM 1999 eKalkarN_neya)ayCatisþIBIkarRKb;RKgBüa)alEfTaMCm¶WkameraKrbs;RksYg suxaPi)al )ankMNt;nUveKalkarN_ “viFIBIry:agrYmKñasMrab;karRKb;RKgEfTaMCm¶WkameraK” (Dual
complementary approach for STI management) kñúgenaHman KøInikkameraKpþl;esvaEfTaM Büa)alCMgWkameraKedaykareFVIeraKvinicäy½Ep¥kelIlT§plénmnÞIrBiesaFn_ sMrab;RkumRbCaCnEdlRbQm muxx<s; CaBiessRsþIbMerIesvapøÚvePT nig esvaBinitü nig Büa)alCMgWkameraKEp¥kelIcegáameraKsBaØa sMrab;RbCaCn TUeTAEdlbB©ÚalkñúgsMNMuskm μPaBGb,brima (MPA) enAmNÐlsuxPaB .
niyaménEbbbTsMrab;GnuvtþskmμPaB (Standard Operating Procedures) rbs;KøInikEfTaM nig Büa)alCMgWkameraK
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
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2- niyaménEbbbTsMrab;RKb;RKgBüa)alCm¶WkameraK 2>1> karRKb;RKgBüa)alCm¶WkameraKenAKøInikkameraK 2>1>1> tYnaTIsMxan;²rbs;KøInikkameraKKW ³
1> pþl;nUvesvaEdlmanRbsiT§iPaB rYmman karBüa)alTan;eBlevladl;GñkCm¶WEdlmaneraK sBaØaCMgWkameraK .
2> BinitüRsavRCav nig Büa)alRbsinebIcaM)ac; nUvRKb;krNICMgWkameraKEdlBMumanelcecjCa eraKsBaØa CaBiess cMeBaHRkumRbCaCnEdlRbQmmuxx<s;nwgeRKaHfñak;énkarqøgCm¶WenH .
3> pþl;esvaBüa)alCMgWkameraKdl;édKUrbs;GñkCMgW . 4> rYmcMENkkñúgkarbgáarTb;sáat;karcMlgemeraKeGds_¼kameraK edayelIkkMBs;karrYmePT
EdlmansuvtßiPaB nigkareRbIR)as;eRsamGnam½y»y)anCab;CaRbcaM . 5> rYmcMENkkñúgRbB½n§RtYtBinitü nigGegáttamdanCMgWkameraKRbkbedayRbsiT§iPaB .
2>1>2> karRKb;RKgKøInikkameraK
edIm,ITak;TajeGayGtifiCnmkBinitüCMgWkameraK KøInikenHRtUvsVaKmn_GtifiCnedayPaBkk;ekþA nigmanpþl;esvananaEdlGtifiCnGacEsVgrk)an .
2>1>2>1> ehdæarcnasm<½n§rbs;KøInikkameraK
ehdæarcnasm<½n§EdltMrUv»ymansMrab;dMeNIrkaresva y:agehacNas;k¾RtUvman ³
o kEnøgTTYlePJóv¼rg;caM ³ Kb,ImankEnøgFMTUlayRKb;RKan;edIm,Ipþl;kEnøgGgÁúydl;GñkCMgW EdlmkBinitü nigrg;caMTTYllT§plBinitüRKb;eBl .
o bnÞb;BieRKaHCMgW ³ RtUvpþl;karrkSakarsMgat;dl;GñkCMgW nigminB¤sMelgsnÞnamkxageRkA. o bnÞb;BinitüCMgW ³ RtUvpþl;PaBs¶at;kM)aMgdl;GñkCMgW edIm,I»yKat;edaHsMelokbMBak;ecj kñúg
karBinitüCm¶WnigsMrab;Rsg;ykvtßúviPaK (specimen). o bnÞb;pþl;RbwkSa ³ Kb,ImanTMhMFMsmlμmsMrab;Gñkpþl;RbwkSaeFVIkarsMPasn_GtifiCnmñak; nig
eBlxøHeRcInnak;kñúgeBlEtmYy . bnÞb;Kb,IFananUvPaBs¶at;kM)aMg nigrkSakarsMgat; rbs;GtifiCn .
o mnÞIrBiesaFn_ ³ Kb,ImanlkçN³smrmüRtwmRtUvsMrab;kareFVIBiesaFn_RsavRCavnana Ca Biess Kb,Idak;bBa©ÚlCaEpñkmYyénmnÞIrBiesaFn_rbs;mnÞIreBTübEg¥kEdlKøInikenaHsßitenA.
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
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2>1>2>2> smasPaBbuKÁlikenAKøInikkameraK
KøIniknImYy²Kb,ImanbuKÁlikRKb;RKan;edIm,IGnuvtþkargardUcxageRkam ³
o kargarcuHeQ μaHGñkCMgW/ rkSakMNt;ehtu nigeFVIr)aykarN_ o kt;RtaRbvtþisuxPaBbnþBUC nigpøÚvePT/ karBinitü nigBüa)al o kareFVIeraKvinicä½yEp¥kelImnÞIrBiesaFn_ o karpþl;RbwkSa o karlagsMGat nigEfTaMsMPar³KøInik
enAKøIniknImYy² manbuKÁlik 4-5 nak; ³
o RKUeBTüBinitüCMgWburs 1 nak; TTYlbnÞúkBinitüGñkCMgWburs/ kt;RtaRbvtþiCMgW/ pþl;RbwkSa o RKUeBTüBinitüCMgWRsIþ 1 nak; TTYlbnÞúkBinitüGñkCMgWRsIþ o Kilanub,dæakyika 1 nak; TTYlbnÞúkkt;RtaRbvtþiCMgW/ pþl;RbwkSa o Gñkbec©keTsmnÞIrBiesaFn_ 1 nak; TTYlbnÞúkeFVIetsþCm¶WkameraK EdlCabuKÁlikmnÞIr
BiesaFn_énmnÞIreBTübEg¥k .
2>1>2>3> Parkic©lMGitrbs;KøInikkameraK
1> pþl;esvaEfTaMBüa)alCMgWkameraKEdlmanKuNPaBx<s; edayeyagtameKalkarN_ENnaM Cati nig niyamEbbbTkñúgkarGnuvtþn_ Edl)anTTYlkarÉkPaBrYcehIy .
2> pþl;karGb;rMsuxPaB nigpþl;RbwkSasmRsbdl;GñkCMgWEdlmkBinitüenAKøInik/ rkSanUvkar sMgat;EdlTak;TgnwgGñkCMgW
3> eFVIeraKvinicä½y nigBüa)alGñkCMgWedayeRbIR)as;BiFIsarCati (National protocols)/ etsþ mnÞIrBiesaFn_ /»sf /]bkrN_ nigsMPar³eRbIR)as;Edlpþl;edaymCÄmNÐlCati nigeRbIR)as; nitiviFIsþg;darEdlgayRsYldl;GñkCMgW nig karbgáarCaskl .
4> Fanafa lT§plEdlTTYlBImnÞIrBiesaFn_ manPaBCak;lak; nigeCOTukcitþ)an .
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
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5> FanafasßanPaBenA KøInik nig mnÞIrBiesaFn_ ¬GKÁIsnI/ m:asuInRtCak;/ ]bkrN_epSg²¦ RtUv)anRtYtBinitüsmRsb edIm,ICYydl;kargar nigFana)annUvkareRbIR)as;sMPar³smRsb nig mansuvtßiPaB .
6> kMNt;)an nigrkSa)annUvkargarRbcaMéf¶rbs;buKÁlikenAKøInik .
7> RbmUlpþMúTinñn½y nigeFVIr)aykarN_skm μPaBRbcaMExmk ¬RsukRbtibtþi¼kariyal½yRbyuT§nwg CMgWeGds_¼mnÞIrsuxaPi)alextþ¦ nig mCÄmNÐlCatiRbyuT§nwgCMgWeGds_ esIEs,k nig kameraK .
8> RKb;RKgsþúk/ karesñIsMu»sf nigsMPar³brikçaeRbIR)as;sMrab;KøInik .
9> raykarN_BI]bkrN_EdlmindMeNIrkar b¤ xUcminGaceRbI)anmk mCÄmNÐlCatiRbyuT§nwg CMgWeGds_ esIEs,k nig kameraK .
10> shkarCitsñiTCamYyRkumkargareRbIR)as;eRsamGnam½y nigkmμviFIGb;rMpÞal;Edlsßitkñúg kargareRbIR)as;eRsamGnam½y 100° .
11> pþÜcepþImKMnitR)ab;GñkCMgWkameraK»yeTAmNÐlpþl;RbwkSa nigeFVIetsþQamrkemeraKeGds_ nigrkSakarsMgat;EdlsmRsb/ karEfTaMBüa)al/ nig esvaEfTaMsuxPaB nig esvaKaMRTepSg² eTot .
2>1>2>4> karbgáarCaskl
edIm,IeCosvagkarqøgeraKBIGñkCMgWeTAGñkCMgW b¤ BIGñkCMgWeTAGñkpþl;esvaEfTaMsuxPaB buKÁlikKøInikTaMgGs; Kb,IeKarBtamcMNucsMxan;²dUcxageRkam ³
• lagéd • eRbIeRsaméd • kan;m¢úl b¤ ]bkrN_mutRsYcedayRbugRby½tñ • eRbIR)as;]bkrN_epSg²edaysuvtßiPaB • e)aHecalkaksMNl;edaysuvtßiPaB
¬Bt’manlMGitGacrk)anenAkñúgeKalkarN_ENnaMsþIBIkarbgáarCaskl¦
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
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2>1>2>5> kareRbIR)as;»sf nigsMPar³eRbIR)as;epSg²
RKb;KøInikTaMgGs; Kb,IFanamin»ydac;sþúknUv»sfcaM)ac;nana EdltMrUv»ymansMrab;kar Büa)alCMgWkameraK ¬dUcmanenAkñúgKMrUsþg;daénkarBüa)al¦ b¤ GacmanlT§PaBrk»sfTaMgGs; enaH)antamry³»sfsßanenAnwgmUldæan b¤ KøInik. karsþúkTuk»sfenAKøInik KW rkSaeGay)annUv nirnþPaBénkarbnþBüa)al nig karpÁt;pÁg;»sfRKb;RKan; . ral;kareRbIR)as;»sf nigsMPar³KøInik Kb,ITukeGay)ansmrmü nig minhYskalbriecäTeRbIR)as; . bBa¢IsareBIP½NÐén»sfsarvnþ½sMxan;² manraykñúg]bsm<½n§TI 4 .
2>1>2>6> ]bkrN_BinitüCMgW
KøIniknImYy²Kb,IEfrkSaeGayRtwmRtUv ]bkrN_sMxan;²sMrab;BinitüCm¶WkameraK Edlmanray enAkñúg]bsm<½n§TI 5 .
2>1>2>7> ]bkrN_mnÞIrBiesaFn_
KøIniknImYy²Kb,IEfrkSaeGayRtwmRtUvnUv]bkrN_eRbIR)as;sMxan;² sMrab;mnÞIrBiesaFn_ Edl manrayenAkñúg]bsm<½n§TI 6 .
2>1>3> karRsg;RbvtþiCMgW
edIm,IRKb;RKgGñkCMgWEdlmkBinitüBüa)alCm¶WenAKøInikkameraKeGaymanRbsiT§iPaB caM)ac;RtUv eFVIkarBinitünigtamdanGñkCm¶W cab;BIedImdMbUgrhUtdl;TIbBa©b;; . kargarenH tMrUveGayRKUeBTükt;Rta RbvtþiCm¶W/ karBinitüCm¶W/ karBüa)al nigkarpþl;RbwkSaGb;rMGñkCm¶W.
bBa¢IRsg;RbvtþiCMgW )anbegáIteLIgedayRkumkargarbec©keTsénkargarEfTaMBüa)alCMgWkameraK edIm,ICYydl;RKUeBTübMeBjnUvBt’mansþIBIRbvtþiCMgW edayrYmTaMgsMnYrEdlTak;TgnwgkarRbRBwtþpøÚvePTEdl Gacecosvag)anBIkaryl;sμanxusGMBICMgW. eBlRsg;RbvtþiCMgW vaCakarsMxan;Nas;EdlRKUeBTüRtUv ³
• Fana»y)annUvkarrkSakarsMgat;rbs;GñkCMgWkñúgeBlpþl;RbwkSaedayRtUverobcM kEnøgEdl KμankarrMxanBIGñkdéTsMrab;eFVIkarsMPasn_. RbsinebIminGacsMPasn_GñkCMgWenAkñúgkEnøg BinitüCm¶W)an RtUveRbIR)as;rnaMg)aMgEdlman tMélefak dUcCa vaMgnn b¤ r)aMgLb;EL ehIyKb,IBüayamniyaytic²kñúgeBlsMPasn_.
• eRbIBaküsamBaزgayyl; CaCageRbIBakübec©keTs
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
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• sYrsMnYrebIk (Open-ended questions) edayminbgá»yGñkCm¶WmankarRBYy)armÖ edIm,ITTYl)annUvcMelIyc,as;las; .
2>1>4> karBinitürkeraKsBaØaKøInik 2>1>4>1> karBinitüragkay nig EpñkxageRkaméneBaH
eKalbMNgkñúgkarBinitüenH KWedIm,IbBa¢ak;BIeraKsBaØaénCMgWkameraKepSg² EdlGñkCMgW)an erobrab;R)ab; . EpñkenH Bnül;GMBIGVIEdlRtUveFVIenAeBlBinitüCMgWburs nig RsIþ .
k> GñkCMgWburs
bnÞab;BIBak;eRsamédrYc ³
o Binitük,al¼k rkemIlsk;EdlRCuH ¬CMgWsVaykMritTIBIr ³ secondary syphilis¦ / kareLIgkUnkNþúr (adenopathy)
o Binitükñúgmat; rkemIl pSit (thrush), duHsac;sirman; (wart) o BinitüEs,kBIp©itdl;CgÁg;rkemIlknÞÜlrmas; (rash) epSg o BinitüEs,ktambeNþayligÁBIKl;dl;cug . kt;sMKal;BIsñamknÞÜl (rash) b¤ dMe)A (ulcer)
epSg². karbgðaj eraKsBaØaCMgWsVaykMritTIBIr (secondary syphilis) KW CaTUeTA elc eLIgenAelIEs,k . eraKsBaØaEdlecjenAelIEs,k KW CaTUeTAminrmas;eT (nonpruritic) ,
manelcecjCaknÞÜlenAelIEs,k (maculopapular) . ry³eBlBI 1 eTA 6 s)þah_ bnÞab;BIdMe)A)anCasHes,Iy CaTUeTAGñkCMgWmanelcecjcMNucknÞÜlRkhmRsalenAelI RbGb;éd nig RbGb;eCIg b:uEnþCYnkalGacecjBaseBjxøÜnTaMgGs; . eraKsBaøaepSgeTot man RKunekþA/ QWbMBg;k/ QWk,al/ karQWcab;enAtamsnøak;édeCIg/ RskTMgn;/ RCuHsk; nigknÞÜlrmas;pgEdr .
o BinitüemIlenAeramelIf¶asRbdab;ePT edIm,IrkemIlsBaØaénkarqøg):ar:asuItEdlrs;enAelI Rbdab;bnþBUC (ecto-parasite infestation)
o sÞabrkemIlkUnkNþúrenARkelonEdlGacrIkFMehIyQWcab; (inguinal lymph node enlargement and tenderness).
o BinitüemIlsñamknÞÜlrmas;enAmþMúRkelon (inguinal folds)
o sÞabemIlBgsVas nigkarQWcab;enABgsVas . édmçagcab;BgsVasRTfñm² mþgmçag ehIy sÞabrkbMBg;eGBIDIDIm (epididymis) edayRmamédEdlkMBugRTBgsVasenaH .
o TajEs,kEdlRKbk,alligÁmkeRkay edIm,IBinitürkemIldMe)A nigkarhUrxÞúH .
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
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o BinitürkemIlenArn§bgðÜrenam edayTajEjkcugsgxag . cUrrkemIlkarhUrxÞúH bJu dMe)A . o c,ÚtelIbgðÜrenam BIKl;ligÁdl;cugligÁ edIm,IBinitüemIl»yc,as;famanhUrxÞúHbJueT .
o BinitürkemIleraKsBaØa hUrxÞúH/ hUrQam/ duHsac; bJu dMe)AepSg² enAmþúMTVarlamk ¬elIPñasesIménfg;lamk nigrn§lamk¦ .
x> GñkCMgWRsþI
bnÞab;BIBak;eRsamédrYc ³
o eRbIBil edIm,IBinitüemIlmat; nigGNþatrkemIleraKsBaØaénkarbgáeraKenAmþúMbMBg; k (pharyngeal)
o saksYrGñkCMgW faetIKat;)aneRtomxøÜnsMrab;eFVIkarBinitüehIybJuenA . RbsinebIKat;)an erobcMxøÜnehIy cUrsMueGayKat;edkelIERKBinitü nigbiTvaMgnnCMuvijERK .
o sÞabEpñkxageRkaméneBaH ³ cUrBinitüemIl nigsÞabeBaHrkkEnøgEdlmankarQWcab;/ mandMu .
o enAmþMúf¶aselIRbdab;bnþBUC ³ BinitürkemIl éc/ duHsac;/ molluscum nig dMe)A .
o enAtMbn;cenøaHTVarmasnigrn§KUf/ tMbn;CMuvijrn§KUf nig rn§KUf ³ BinitürkemIleraKsBaØaepSg² dUcCa sirman;/ dMe)A TVarlamk .
o bbUr (Labia) nigmat;rn§TVarmas (introitus) ³ Ejk nig BinitüemIlelIbbUrFM (labia
majora) / bbUrtUc nigmat;rn§TVarmas rkemIlsirman;/ dMe)ABgEbk (herpes lesions) / Føak; s bJuhUrxÞúHtamTVarmas/ nigkarrlakenARkeBj Bartholin.
o karBinitües<KULÚm edaymindak;eRbgrMGil/ BinitüemIlBN’rbs; s EdlecjBITVarmas/ brimaN/ køin/ PaBkkdMu² nig kMhab; . cUrBinitüenAelICBa¢aMgTVarmas nigmat;s,Ún edIm,IrkemIlsirman; bJu dMe)A nigBinitümat;s,ÚnrkemIlkarFøak; s bJu hUrxÞúH .
2>1>4>2> karRbmUlvtßuúviPaK (Specimen)
• enATVarmas ³ Rsg;ykvtßúrav (vaginal fluid) enAkñúgTVarmasEpñkxageRkayénmat; s,Ún (posterior fornix) edayeRbIR)as;sMLIt,ar (swabs) BIr nigeCosvag karRsg; ykedayvtßúravecjBImat;s,Ún (cervical secretions). sMLIt,arTImYy RtUvykmk remolenAelIkBa©k;Lam (microscope slide) Tuk»ys¶Üt edIm,IbMBak;B’NRkam (Gram stain) sMrabeFVI;viPaKedaymIRkUTsSn_ . kBa©k;LamTIBIr sMrab;karviPaKRss;² Pøam² (wet preparation).
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
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• enAmat;s,Ún ³ cMeBaHsMLIEdlt,arenAkñúgmat;s,Ún RtUvrujremolenAkñúgrn§mat;s,Ún ry³eBl 10 vinaTI eRkayBIsMGatelImat;s,ÚnehIy. bnÞab;mkRtUvrujremol enAelI kBa©k;LamsMrab;viPaK rYcTuk»ys¶Üt edIm,IbMBak;B’N methylene blue sMrab;eFVI;viPaK rkcMnYneKalika s edaymIRkUTsSn_ .
• karbUmQam ³ bUmQamcMnYn 5cc dak;kñúgbMBg;TIbs¶ÜtEdl)ansMlab;emeraKrYc ehIy manqñúkbiTCit KWCaviFIEdleFVICaRbcaMsMrab;GñkEdlmkBinitüelIkTI 1 .
2>1>5> kareFVIetsþenAmnÞIrBiesaFn_
kareFVIetsþrkemeraKbgáCm¶WkameraK RtUv)andak;bBa©ÚlCaEpñkmYyrbs;mnÞIrBiesaFn_énmnÞIreBTü bEg¥kEdl KøInikkameraKenaHsßitenA .
2>1>5>1> kareFVIetsþrkemeraKbgáCm¶WkameraKenAmnÞIrBiesaFn_
• enAkñúgbnÞb;BiesaFn_/ QamEdlbUmykBIGñkCm¶W RtUvRsg;ykEtesr:Um edaykarbMEbkeKalika QamRkhmecj tamry³karbgVilnwgm:asuInsg;RTIhVúy (centrifugation). esr:UmenH nwgRtUv eRbIsMrab;eFVIetsþ RPR tamEbbKuNPaB (qualitative) nigtamEbbbrimaN (quantitative)
edaykarBinitükMritviC¢manénetsþ (titre) Ep¥ktameKalkarN_ENnaMsþIBIkareFVIetsþnana enAmnÞIr BiesaFn_sMrab;kareFVIeraKvinicäy½Cm¶WkameraK .
• Gñkbec©keTsmnÞIrBiesaFn_RtUveFVIetsþPøam² (wet preparation) nUvvtßúravRss;² Edl)anRsg; ykenAkñúgTVarmas (vaginal fluid) EpñkxageRkayénmat;s,Ún (posterior fornix) edIm,I BinitüedIm,IrkemIlemeraKRTIkUm:UNas; (Trichomonas vaginalis) EdlkMBugeFVIclnarvic² (motile flagellates) nigrkemIlBBYkpSitEdlman ragCaExñg b¤ EmkeQI (yeast) (hyphae
and budding yeasts) . • s bJu vtßúravEdlRsg;ykecjBITVarmasRtUveFVI»ys¥itCab; (staining) CamYykBa©k;Lam bnÞab;
mkRtUvbMBak;B’NRkam Gram stain edIm,IrkemIl pSit (yeast) b¤ BBYk bacterial vaginosis
(BV) tamviFI Nugent scores . • s bJu vtßúravEdlRsg;ykecjBImat;s,ÚnRtUveFVI»ys¥itCab; (staining) CamYykBa©k;Lam bnÞab;
mkRtUvbMBak;B’N Methylene blue edIm,IBRgIkemIledaymIRkUTsSn_rab;cMnYn eKalikaQam s . RtUvBinitü»y)any:agehacNas; 10 rgVg;emIlkñúgmIRkUTsSn_ (10 adjacent fields) munnwg KNnarkcMnYnmFüméneKalikaQam s enH.
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 9 -
lT§plénetsþTaMgenaHRtUvsresrenAelIbNѽviPaK ehIybBa¢Únmk»yRKUeBTüvij edIm,IeFVIeraK vinicäy½nigpþl;nUvkarBüa)alNamYyEdlcaM)ac;dl;GñkCm¶W . Gñkbec©keTsmnÞIrBiesaFn_ Kb,Ipþl;nUv lT§plenaH kñúgkMlugeBlEdlGñkCm¶WkMBugrg;caMenAKøInik .
2>1>6> karRtYtBinitüKuNPaBmnÞIrBiesaFn_
niyaménEbbbTGnuvtþ (SOP) KWCaEpñkmYysMxan;énRbB½n§RKb;RKgKuNPaBnana . karRtYt BinitüKuNPaBenAkEnøgepSg (Quality Control : QC) Tak;TgnwgKøInikkameraKextþ-Rkug nwgRtUv eFVIeLIgedaymnÞIrBiesaFn_énKøInikCatiesIEs,knigkameraK .
eKalbMNgénkarRtYtBinitüKuNPaBenH KW edIm,IbBa¢ak;BIsuRkitPaBénlT§plEdl)anviPaK enAtammnÞIrBiesaFn_kameraKextþ-RkugnImYy² . dUecñHmnÞIrBiesaFn_Edl)aneFVIetsþ RPR, Methylene
blue nig Gram stains RtUvbBa¢ÚnKMrUvtßúEdlviPaKehIyenaH (Specimen) mkRtYtBinitüeLIgvijenA mnÞIrBiesaFn_énKøInikCatiesIEs,knigkameraK tameKalkarN_dUcxageRkam ³
k> etsþ RPR
1> RKb;esr:UmQam (serum specimen) TaMgGs;Edl RPR viC¢man RtUvbBa¢Únmk mnÞIrBiesaFn_énKøInikCatiesIEs,knigkameraK .
2> cMeBaHesr:UmQam (serum specimen) TaMgGs;Edl RPR GviC¢man ³
k> RbsinebIman specimen ticCag 10 kñúg 1 Ex RtUvbBa¢ÚnmkTaMgGs;
x> RbsinebIman specimen cenøaHBI 11 eTA 50 kñúg 1 Ex RtUvbBa¢Únmk 30°
K> RbsinebIman specimen elIsBI 50 kñúg 1 Ex RtUvbBa¢Únmk 20°
x> vtßúviPaKEdlRsg;ecjBIrn§mat;s,Ún nigTVarmas (Cervical and vaginal smear)
1> Smear viC¢man ³ RtUvbBa¢ÚnmkmnÞIrBiesaFn_TaMgGs;
2> Smear GviC¢man ³
k> RbsinebIman specimen ticCag 10 kñúg 1 Ex RtUvbBa¢ÚnmkTaMgGs;
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 10 -
x> RbsinebIman specimen cenøaHBI 11 eTA 50 kñúg 1 Ex RtUvbBa¢Únmk 30° K> RbsinebIman specimen elIsBI 50 kñúg 1 Ex RtUvbBa¢Únmk 20°
2>1>7> eKalkarN_ENnaMsMrab;karBüa)al
karBüa)alqab;rh½s nigmanRbsiT§iPaBGackat;pþac;dMeNIrkarénkarqøg nigbgáarnUvkarvivtþn_ én Cm¶WEdlQaneTArkplvi)akF¶n;F¶rnana nigplb:HBal;dl;ragkaykñúgry³eBlEvg .
2>1>7>1> karBüa)al
cMeBaHRKUeBTüBüa)alTaMgGs; Kb,IRKb;RKgCMgWkameraKedayeKarBtameKalkarN_ENnaM CatisþIGMBIkarRKb;RKgnigEfTaMCMgWkameraK .
2>1>7>2> kareRbIR)as;»sf nigRbtikm μ»sf
BinitürkemIlkareRbIR)as;»sf nigRbtikmμén»sfTaMgenaH . cUrsaksYrGMBIkareRbIR)as; »sfnaeBlfμ I²enH nigRbtikm μepSgEdlekItmaneBleRbIR)as;»sf .
2>1>8> Bt’man/ karGb;rM nigkarpþl;RbwkSa
bnÞab;BICYbCamYyevC¢bNÐit¼RKUeBTü ral;GtifiCnTaMgGs;RtUv)anTTYlnUvkarpþl;RbwwkSasþIBICMgW eGds_ nigkameraK/ eRsamGnam½y nigkarbgðajGMBIkareRbIR)as;eRsamGnam½y/ pþl;dMbUnμanGMBIkar RbRBwtþRbQmmuxnwgeRKaHfñak;EdlnaMeGayqøgCm¶W .
2>1>8>1> karpþl;RbwkSa
• EsVgrk nigedaHRsayral;bBaðaTaMgGs;EdlGacbNþaleGayGñkCMgWmankgVl; b¤ TukçRBYy ¬]> pþl;Bt’mandl;édKU¼bþIRbBn§GMBIkarqøg/ Gb;rMBICMgWkameeraKEdlGacnaMmknUv plvi)ak nana dUcCa GsmßPaBbnþBUC/ CMgWruaMér:¼CMgWEdlminGacBüa)alCasHes,Iy)andUcCa CMgWdMe)A BgEbk (herpes) bJu sirman;elIRbdab;bnþBUC (genital wart)/ edaHRsayGarmμN_Edl ecHEtKitfaxøÜnmanCm¶W .
• CYyGtifiCneGayTTYlsÁal;nUv]bs½KÁnanakñúgkarkat;bnßykarRbQmmuxnwgeRKaHfñak; • CYyGtifiCneGaykMNt;rknUvviFIeCosvagkarRbRBwtþEdlRbQmmuxnwgeRKaHfñak; • CYydl;GtifiCn»ycab;epþImpøas;bþÚrkarRbRBwtþ
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 11 -
2>1>8>2> karGb;rM
• BiBN’naBIviFIeCosvagkarqøgeraKCaf μ ImþgeTot • Bnül;BIviFIkt;sMKal;eraKsBaØanana nig sarsMxan;énkarEsVgrkkarBüa)alCMgWkameraKTan;
eBlevla • pþl;eyabl;dl;GtifiCnEdlRbQmmuxx<s;nwgeRKaHfñak; eGayEsVgrkmNÐlpþl;RbwkSaeFVI
etsþQamrkemeraKeGds_ edaysμRK½citþ nigrkSakarsMgat; • pþl;b½NÑBinitünigBüa)alEdlmanelxkUdsMKal;dl;RsþIrksuIpøÚvePT . b½NÑenHminman
eQμaHrbs;Gñkkan;b½NÑeT . b½NÑenH nwgRtUveRbIR)as;sMrab;karmkBinitüRbcaMExenAKøInik kameraK .
2>1>8>3> karRbtibtþitamevC¢bBa¢aRtwmRtUv-eTogTat; nigCab;lab;
• epþatkarykcitþTukdak;kñúgkarEfTaMBüa)al»y)ancb;sBVRKb; CaBiess krNICMgWrlak Eb:lvIs (PID)
• RtUvFanafa GtifiCn)andwgfa eBlNaRtUvRtLb;mkBinitütamdanCMgWmþgeTot . burs nigRsþIempÞH KYrKb,IRtLb;mkvijenAeBlEdlBYkeKenAmaneraKsBaØa . k¾b:uEnþcMeBaH RsþIrksuIpøÚvePT RtUvmkBinitüCMgWenAKøInikCaerogral;Ex ebIeTaHbICaBMumaneraKsBaØak¾eday.
• pþl;eyabl;dl;GtifiCn GMBIsar³sMxan;kñúgkareRbIR)as;»sftamevC¢bBa¢aRtwmRtUv ehIykar eRbIR)as;»sfEdlBüa)aledayRKUbUraN b¤Gñklk;»sf minmanRbsiT§iPaBkñúgkarBüa)al CMgWkameraKeT .
• Kb,IsYrGtifiCnfa etIBYkeKGacdwgCamun)anbJueT BI]bsKÁ½epSg² kñúgkareRbIR)as;»sf Büa)al»y)ancb;sBVRKb;¼tamdankarbBa¢ÚnCMgW nigrkdMeNaHRsayepSg² .
2>1>8>4> eRsamGnam½y
• epþatkarykcitþTukdak; nig Bnül;GMBIsarsMxan;énkareRbIR)as;eRsamGnam½ysMrab;kar karBar ¬karBarkarqøgCMgWkameraK¼emeraKeGds_ nigkarmanKP’edaymin)aneRKagTuk¦
• Bnül; nigbgðajBIrebobeRbIR)as;eRsamGnam½y nigsMueGayGtifiCnbgðajBIkareRbIR)as; enHpgEdr .
• pþl;eRsamGnam½ymYycMnYndl;GtifiCn .
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 12 -
2>1>8>5> karBieRKaHtamdanCMgW
• RbsinebImankarBüa)al b¤ pþl;»sf»yeRbIR)as; sUmesñIGñkCMgWeGayRtLb;mkvijenA s)þah_eRkay edIm,IBieRKaHtamdansPaBCMgW .
• cMeBaHRsþIrksuIpøÚvePT RtUveGaymkBinitüCMgWCaeTogTat;erogral;Ex k¾b:uEnþeTaHCay:agNa k¾eday GñkCm¶WKYrRtLb;mkvijenARKb;eBl RbsinebImankar)armÖBIeraKsBaØaNamYy .
2>1>9> karRKb;RKgTinñn½y 2>1>9>1> karbMeBjsMNMuÉksarRbvtþiCMgW (Standard Medical History)
RKb;kMNt;ehtuTaMgGs; RtUvrkSaTukenAkEnøgdUcKña . vaGacFanamin»ymankar)at;bg; Bt’man ehIyral;Bt’manTaMgGs;GacnwggayRsYlrk .
sMNMuÉksarRbvtþiCMgW (SMH) sMrab;RsþIrksuIpøÚvePT nwgRtUvrkSaTuktameQμaHpÞHbMerIesvapøÚv ePT nimYy² .
2>1>9>2> RbBn§½Tinñn½yCMgWkameraKtamkMBüÚT½r (STI Database)
buKÁlikKøInikTaMgGs;Kb,IbBa©ÚlTinñn½yeTAkñúgkMBüÚT½reGayTal;eBlevlakñúgs)aþh_ bnÞab;BI karBieRKaHnigBinitüBüa)alCMgWrYcmk .
2>1>9>3> r)aykarN_
1> kareFVIr)aykarN_)anl¥RtwmRtUvGacCYy»ykm μviFICati BinitütamdanesvaénKøInikkameraK ehIyGnuBaØat»ykarvaytMélénkmμviFIenaHmann½yRKb;RKan; . ¬sUmemIlKMrUr)aykarN_ mYycMnYnenA]bsm<½n§TI 7¦ .
2> TMrg;r)aykarN_TaMgGs;RtUvbMeBjeGay)anRtwmRtUv ehIyepJImkkan;EpñkRKb;RKgTinñn½y én mCÄmNÐlCatieGay)aneTogTat;nigTan;eBlevla ¬r)aykarN_RbcaMEx/ RbcaMRtImas nig RbcaMqñaM¦ .
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 13 -
3- karelIkkMBs;smtßPaBmRnþIKøInikBüa)alCm¶WkameraK
karelIkkMBs;smtßPaBmRnþIEdlbMerIkarenAKøInikBüa)alCm¶WkameraK nig mnÞIrBiesaFn_ RtUv)an kMNt;CaGaTiPaBmYy edIm,IFananUvkareFVI»ykan;EtRbesIreLIgnUvkarpþl;esvaEfTaMBüa)alkarbgáeraK tamkarrYmePTnigRbdab;bnþBUC EdlRbkbedayKuNPaBnigRbsiTi§PaBx<s; CaBiesskareFVIeraKvinicäy½ nigBüa)alCm¶WedayBwgEp¥kelImnÞIrBiesaFn_ . EpñkRKb;RKgBüa)alkarbgáeraKtamkarrYmePT nigRbdab; bnþBUC RtUvshkarCamYyKøInikCatiesIEs,knigkameraK edIm,IbNþúHbNþalCMnajbec©keTs TaMgKøInik nig mnÞIrBiesaFn_ CUndl;mRnþIKøInikkameraKextþ-RkugTaMgGs;enaH .
3>1> karbNþúHbNþaldMbUg (Initial training) 3>1>1> karbNþúHbNþaldMbUgdl;Gñkpþl;esvaEfTaMBüa)al
Gñkpþl;esvaEfTaMBüa)alCm¶WkameraK RtUv)anbNþúHbNþalCMnajCaelIkdMbUgry³eBl 2s)þah_ ¬RTwsþI 1 s)þah_ nig km μsikSa 1 s)þah_¦ enAkñúgvKÁRKb;RKgEfTaMnigBüa)alCm¶WkameraK Edlman rYmbBa©Úl ³
• karRKb;RKgnigEfTaMBüa)alCm¶WkameraKedayBwgEp¥kelIcegáameraKsBaØa • karRKb;RKgnigEfTaMBüa)alCm¶WkameraKedayBwgEp¥kelImnÞIrBiesaFn_ • karRKb;RKgnigEfTaMBüa)alCm¶WkameraKenAelIRsþIrksIupøÚvePT
3>1>2> karbNþúHbNþaldMbUgdl;Gñkbec©keTsmnÞIrBiesaFn_
Gñkbec©keTsmnÞIrBiesaFn_sMrab;Cm¶WkameraK RtUv)anbNþúHbNþalCMnajCaelIkdMbUgry³eBl 2 s)þah_ ¬RTwsþI 1 s)þah_ nig kmμsikSa 1 s)þah_¦ enAkñúgvKÁbNþúHbNþalbec©keTs mnÞIrBiesaFn_ sMrab;RsavRCavCm¶WkameraK .
3>2> karbNþúHbNþalbMb:n (Refresher training) 3>2>1> karbNþúHbNþalbMb:nGñkpþl;esvaEfTaMBüa)al
Gñkpþl;esvaEfTaMBüa)alCm¶WkameraK Edl)anbNþúHbNþalCMnajCaelIkdMbUgrYcehIy RtUv)an eRCIserIs»ycUlrYmkñúgkarbNþúHbNþalbMb:nCMnajnigcMeNHdwgfμ I²sþIBI karRKb;RKgBüa)alkarbgáeraK tamkarrYmePTnigRbdab;bnþBUC EdlerobcMeLIgCaBIrvKÁ ry³eBl 3éf¶ Caerogral;qñaM .
HfmmmgWH21'titLUlwBwmhlHmmnei ttlruUl2mUlmllillruG21mthtrun~Ui1HmSim d; 1J. '-'" .., r: n -o v u
rnIUlEHlt1wi1w~m~ru~HrJi1rnmrrr!m[l-nlrulh1BG21Q] Bi1 ~HlmBi1Y9 ~~rnl1mei2121wmhg , ,
mei1Byill Bi1 njlUlrurnm~mmi1Hrnr~HU'i9Bi1lUtl1UU~~tl ttlruUju~mji1th~rI~ Hu:mru
mt~ thtrji1mli;fJ ~
aI.Qt. uRWBnmritims (Regional network)
t~Hj~mHrnui1rnnBiTIBnrnmneimsru~mtlfijnJltU'SflJU'iBi1ttinrtrunUg'titLUlwBrrnm
1Q]tmHri ~TIBn~mtmTIBn~mmjn 9li1rnr'tiBnjnj1Ulrutlg Bi1rnr1mei2121tBiH~I'titLUlWB
TIBnrnHmei9li1t21g rnIUlStU'U~~mmsthurrr!1Q]mfigi1rJltmmm'iUBB~m9 :
• ftUSg ID : NtltimH. Ntltiii. tttltIi1 Bi1 ~mUji1
• rmS9 m: Ulft~Ui1. u~mmstlriL Lryi1trrrus. a~rmstlill. tWjHnu Bi1 tmGLUlft
• ftUB9 G: mtriI. ~tln. Lryi1lm~Ul~ Bi1 trngryi1
• ftUB9 ef : lmm. ~i1tlni1. ms:m. HUQrum Bi1 lm1Ul11 '1
Ulli1:)CU9li1tsgBi1~U~rJl rli1 fijlJlLUlrulwmw~ruU[l~CU TIBnrnmnm2~ -Lryi1 ttlruTIJl[i~ I
tmmj:mru I£J t~ qi1~mif1~i1 tBimHUU!rt2~-Lryi1ttlruTIBn9li1t21g~mBi ttl1m~w¥nrB~
thtrji1mli;fJ '1
t~nleiUleii1tlJlUlrurnm~meimHrnl~ml'ig Bi1 lutl1uu~~tl rnItruninni1131rnlum;fJ
tmmWUlrnnU'u~fijlJlt'UlrultBgth~mTIBnth~htlitwjriBi1mHmei '1
- 0G
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 15 -
]bsm<n§½TI 1 ³ RbvtþinigmUlehtuénkarmkBieRKaHCMgW
RKUeBTüKb,Irk»yeXIjnUv eraKsBaØaEdl)anerobrab;R)ab;edayGñkCMgW EdlbBa¢ak;»yeXIj nUvvtþmanénCm¶WkameraK nigry³eBlEdlEsþgecjCaeraKsBaØarYmman ³
1- cMeBaHGñkCMgWRsþI
• Føak; s ¼ hUrxÞúHtamTVarmas (Vaginal discharge)
• QWcukcab;enAEpñkxageRkaméneBaH (Lower abdominal pain)
• QWcab;enAeBlrYmePT (Painful intercourse)
• rlak (Lesion)
• Bi)akenam (Dysuria)
• RKunekþA (Fever)
• rmas;TVamas (Itching vaginal)
• eraKsBaØaepSg²eTot (Others) edaybBa¢ak;»yc,as;BIeraKsBaØaenaH • KμaneraKsBaØa (No symptoms)
2- cMeBaHGñkCMgWburs
• hUrxÞúHtambgðÜrenam (Urethral discharge)
• dMe)AenAelIRbdab;bnþBUC (Genital ulcer)
• sirman; (Genital warts)
• ehImBgsVas nigmankarQWcab; (Scrotal pain/swelling)
• Bi)akenam (Dysuria)
• rmas;knÞÜlelIEs,k (Skin rash)
• ehImkUnkNþúr (Adenopathy)
• hUrxÞúHtamrn§KUf (Anal discharge)
• eraKsBaØaepSg²eTot (Others) edaybBa¢ak;»yc,as;BIeraKsBaØaenaH • KμaneraKsBaØa (No symptoms)
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 16 -
]bsm<n§½TI 2 ³ RbvtþiénkarBnüakMeNItsMrab;RsþI
karbgáar nig ral;karBak;B½n§eTAnwgkarbgáeraKtamkarrYmePTnigRbdab;bnþBUC (STI/RTI) Kb,I RtUv)anelIkykmkBiPakSaCamYyRKb;GtifiCnTaMgGs;rbs;esvaBnüakMeNIt enARKb;eBlEdlBYkKat; mkBinitüCm¶W ³
o eRbIR)as;esvaBnüakMeNIt dUcCa fñaMcak;/ fñaMRKab;/ eRsamGnam½y/ dak;kgeRkamEs,k (Implant), dak;kg (IUD)
o cMnYndgénkarmanépÞeBaH/ cMnYnkUnEdlkMBugrs;enA o cMnYndgénkarBnøÚtkUn bJurlUtkUnedayÉkÉg (Induced or spontaneous) o karmkrdUvcugeRkay
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 17 -
]bsm<n§½TI 3 ³ karRbRBwtþEdlRbQmmuxx<s;nwgeRKaHfñak;
Kb,IrkeXIjnUv karRbRBwtþEdlRbQmmuxx<s;nwgeRKaHfñak; EdlCH\T§iBldl;suxPaBpøÚvePT rbs;GtifiCn rYmman ³
1- sMrab;RsþI ³
o etIGñkCMgWyl;dwgGMBIviFIeRbIR)as;eRsamGnam½yEdrb¤eT ? o etImanGtifiCneTogTat;¼mitþRbusb:un μannak;kñúgkMLúg 3 Exknøgmk ? o etIRbRBwtþrYmePTtamviFIEbbNaCamYyGtifiCn¼mitþRbus ¬]> rYmePTtamTVarmas/
tammat;/ b¤tamrn§KUf¦ o etImaneRbIeRsamGnam½yenAeBlrYmePTcugeRkayCamYyGtifiCn¼mitþRbusbJueT? o sYrGMBIRbePTfñaMejónEdleRbIR)as;edayGñkCm¶W ¬RbsinebImaneRbIR)as;¦
2- sMrab;burs ³
o etImanédKUrYmePTb:un μannak;kalBIqñaMmunknøgmk? o etImaneRbIR)as;eRsamGnam½ybJueT enAeBlrYmePTelIkcugeRkay? o manédKUrYmePTécdnübJueT kñúgExknøgmk ? o etIFøab;manekItCMgWkameraKEdrb¤eT ? o etIGñkCm¶WmaneRbIR)as;fñaMejónEdrb¤ enAeBl\LÚvenH ?
3- sMnYrbEnßmeTotsMrab;bursrYmePTCamYyburs ³
o etIGñkmanrYmePTCamYyburs/ RsþI b¤ TaMgBIrePT ?
o etICaTUeTAGñkrYmePTtammat; b¤ tamrn§KUT?
o etIGñkcUlcitþ»yeKbBa©ÚlRbdab;ePTmkkñúgmat;¼rn§KUfrbs;xøÜn (Receptive sex) bJu cUlcitþbBa©ÚlRbdab;ePTxøÜneTAkñúgmat;¼rn§KUfrbs;eK (Insertive sex) ?
4- karvaytMélBIkarRbQmmuxnwgeRKaHfñak;
cMeBaHCMgWrlakmat;s,Ún (Cervicitis) karRbQmmuxnwgeRKaHfñak;KWmansarsMxan;Nas;kñúg karvaytMélelIRsþIEdlmanCm¶WFøak; s bJuhUrxÞúHtamTVarmas (Vaginal discharge) EdlGacmanCm¶W rlakmat;s,Ún nig rlakTVarmas (Vaginitis) dMNalKñakñúgeBlEtmYy EdlpÞúyeTAnwgGñkEdlman
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 18 -
Cm¶WrlakTVarmasEtmYymux . vak¾Ca]bkrN_mYysMxan;EdrkñúgkarBinitüRsavRCavRsþIEdlK μaneraKsBaØa CMgWkameraK kñúgkrNIEdlKøInikenaHBMumansmtßPaBeFVIeraKvinicä½yedayBwgEp¥kelImnÞIrBiesaFn_ .
4>1 karvaytMélelIkarRbQmmuxnwgeRKaHfñak;cMeBaHRsIþrksuIpÚøv ¬edaypÞal; nigRbeyal¦
rkeGayeXIjnUvsBaØaeRKaHfñak;cMeBaHCMgW cervicitis sMrab;RsþIrksuIpøÚvePTeday Ep¥kelI ³
• manhUrxÞúHelOgxab;tamTVarmas (Thick yellow discharge) • mankarQWcab;EpñkxageRkaméneBaHkñúgeBlrYmePT ¬QWcab;xøaMgdUcCab:HTgÁic¦ • rYmePTCamYyePJóv CamFüm elIsBI 5nak; kñúg 1éf¶ • rYmePTedaymin)aneRbImeFüa)aykarBarCamYyePJóvfμ I²
RbsinebIcMelIy ca+ elIsBIrsMnYr b¤ eRcInCagenH/ cUrBüa)alCMgWrlakmat;s,Ún . m:üageTotRtUveFVIkarBinitüEpñkeRkaméneBaH (Pelvic) pgEdr . kareRbIR)as;karvaytMél elIkarRbQmmuxnwgeRKaHfñak;cMeBaHRsþIrksuIpøÚvePT ¬edaypÞal; nig Rbeyal¦ manBnül; enAkñúg eKalkarN_ENnaMsþIGMBIkarRKb;RKgCMgWkameraK sMrab;RsþIrksIupøÚvePT.
4>2 karvaytMélelIkarRbQmmuxnwgeRKaHfñak;cMeBaHRbCaCnTUeTA
RsþImYycMnYnEdlenAkñúgRkumminsUvRbQmmuxx<s;nwgeRKaHfñak; ¬dUcCa RsþIempÞH¦ Edl eK)anKitfanwgmkBinitüCMgWenAKøInikkameraKenaH cUlcitþeTABinitüCm¶WenAmNÐlsuxPaBCag. eTaHbICay:agNak¾eday/ Gñkpþl;esvaEfTaMsuxPaB Kb,IykcitþTukdak;cMeBaHRsþIkñúgRkum RbCaCnTUeTAenAeBlNaEdlBYkeKmkBinitüCm¶WenAKøInikkameraK . enAeBlCYbGtifiCnEdl mankart¥ÚjEt¥rGMBIkarFøak;stamTVarmas (Vaginal discharge) Gñkpþl;esvaEfTaMsuxPaB Kb,IeFVIkarvaytMélBIkarRbQmmuxnwgeRKaHfñak;dUcxageRkam ³
• GñkCMgWt¥ÚjEt¥BIkarQWcab;EpñkxageRkaméneBaH b¤ • édKUmaneraKsBaØaCMgWkameraK b¤ • GñkCMgWmankarRbQmmuxnwgeRKaHfñak; “ viC¢man ” ³
o GñkCMgWmanGayuticCag 25qñaM o GñkCMgWminTan;erobkar Etskm μPaBpøÚvePT
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 19 -
o GñkCMgWrYmePTCamYyédKUeRcInnak;kñúgry³eBl 3 Exknøgmk o GñkCMgWmanédKUfμ Imñak;kñúgry³eBl 3 Exknøgmk
kareRbIR)as;edayRtwmRtUvnUv karvaytMélénkarRbQmmuxnwgeRKaHfñak;sMrab;RsþIkñúgcMeNam RbCaCnTUeTA KWmanBnül;enAkñúgeKalkarN_ENnaMCati sþIGMBIkarRKb;RKgniEfTaMCMgWkameraK .
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 20 -
]bsm<n§½TI 4
KMrUbBa¢IsareBIP½NÐsMrab;karRtYtBinitü»sfsarvnþ½ nigbrikçaepSg² (INVENTORY FORMS FOR ESSENTIAL DRUGS AND OTHER CONSUMABLES)
sMPar³TaMgenHRtUvesñIsuM»y)aneTogTat;eBlevlaEdl)ankMNt; . tamkareRbIR)as;KMrUbBa¢I sareBIP½NÐenH bJuKMrURbhak;RbEhlnwgKMrUenH GñkGactamdanCab;lab;nUvsareBIPNнnanaEdlman nig )a:n;RbmaNdwgBItMrUvkarCak;Esþg edIm,IesñIsMubEnßmeTAtamRbePT »sf bJu brikçarnana .
KMrUbBa¢IsareBIP½NÐsMrab;karRtYtBinitü»sf (INVENTORY FORM FOR DRUGS)
eQμaH»sf brimaNkñúgsþúk brimaNRtUvkar brimaNesñIsMu kalbriecäTesñIsMu kalbriecäTTTYl Azithromycin 500mg
Cefixime 200mg
Cetriaxone 1g IM
Spectinomycin 2g IM
Benzathine PN 2,4UI IM
Metronidazole 250mg
Clotrimazole 500mg
Nystatine 20000UI
Erythromycin 250mg
Doxycycline 100mg
Cotrimoxazole 960mg
Podophyllin 25% solution
Ciprofloxacine 500mg
Acyclovir 200mg
Gentian violet solution
»sfepSg²eTot
>>>>>>>>>>>>>>>>>>>>>>>>>>
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 21 -
KMrUbBa¢IsareBIP½NÐsMrab;karRtYtBinitübrikça (INVENTORY FORM FOR CLINICAL CONSUMABLES)
eQμaHbrikça brimaNkñúgsþúk brimaNRtUvkar brimaNesñIsMu kalbriecäTesñIsMu kalbriecäTTTYl Gloves surgical sterile disposable (size: 6.5 Pair)
Syringe disposable 10ml
Needle disposable, 21Gx1/2”
Cotton wool (roll of 500g)
Alcohol 70oc
Antiseptic
Sterile cotton swab
Disposable tongue depressor
Soap
Tissue box
Sharp safe bin
Standard medical history
Condoms
SHMs women (1st visitors)
SMHs women (follow-up)
Clinical card
Laboratory bulletin form
Clinical register
Laboratory register
Torch
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 22 -
]bsm<n§½TI 5
KMrUbBa¢IsareBIP½NÐsMrab;karRtYtBinitüsMPar³eRbIR)as; (INVENTORY FORMS FOR ESSENTIAL DRUGS AND OTHER CONSUMABLES)
bBa¢IsareBIP½NÐenHCYyGñk»ytamdanCab;lab;nUvsMPar³eRbIR)as;nanaEdlman enAnwgKøInik rbs;Gñk . sareBIPNнTaMgenH KYrEtcaM)ac;esñIsMuEtmþgKt; enAeBlcab;epþImdMeNIrkaresva elIkElgEtkñúgkrNIEdlmankarEbk)ak; bJucas;eBkminGaceRbIkar)an eTIbGacesñIsMuCafμ ImþgeTot .
bBa¢IraysMPar³eRbIR)as;enAKøInik (LIST OF CLINICAL EQUIPMENT AND MATERIALS)
sMPar³eRbIR)as;enAKøInik brimaN
Gynecological examination table folding 2 sections with pad -1,8 long, 60 cm wide, 75 cm high, folding table with top in two sections, removable and adjustable, plastic covered and polyurethane field pad , pair chrome-plated large bierhoff knee crutches
01
Revolving stool adjustable high -Steel enameled finish, 36 cm diameter Seat adjustable from 48 to 66cm
01
Carriage dressing -Carriage, dressing, knock-down construction: with 2 shelves approx 90x 45cm), Stainless steel
01
Sterilize hot air - Internal size approx 70 cm long x50cm deep x 70cm high - Power: 220 volts-50Hz
01
Clinical thermometer oral dual CELS/FAHR scale - Prismatic type, lens front, cylindrical bulb
02
Stethoscope -Stethoscope binaural complete for adult
01
Sphygmomanometer - Sphygmomanometer aneroid 300mm with cuff & pouch
01
Tray instrument covered -Stainless SLEEL approx: 31x20x6cm
02
Drum sterilizing cylindrical -Stainless steel construction, diameter 24cmx16cm high -Stainless steel construction, diameter 12cmx9cm high
02
Speculum vaginal bivalves -Glaives small (Duckbill vaginal speculum): 75x25mm
20
Speculum vaginal bivalves -Glaives small (Duckbill vaginal speculum): 90x30mm
30
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 23 -
Forceps -Uterine dressing Bozeman 260mm
40
Forceps -Uterine holding, straight 200mm
10
Forceps jar -Jar forceps 180mm long polypropylene
02
Scissors -Curved dissection scissors “MAYO”145mm, stainless steel
05
Scissors -Scissors surgical straight 145mm stainless steel
05
Solution cup -180ml stainless steel: top diameter 83mm, bottom51mm high
05
Tray cafeteria -Type 350x450mm, polypropylene
03
Kidney basin -475ml stainless steel
05
Kidney basin -825ml stainless steel
05
Electro-cauterization “ELECTOTOM 505” -voltage: 110-120v 60Hz, Dimension: 86mm, 250mml,235mmP, weight: 3.8kg
01
Light operating stain mobile 220volt 02
Cryotherapy (liquid nitrogen) ** (alternative option of electro-cauterization)
01
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 24 -
]bsm<n§½TI 6
KMrUbBa¢IsareBIP½NÐsMrab;karRtYtBinitüsMPar³brikçaeRbIR)as;enAmnÞIrBiesaFn_ (INVENTORY FORM FOR LABORATORY EQUIPMENT AND CONSUMABLE)
bBa¢IraysMPar³eRbIR)as;enAmnÞIrBiesaFn_ (LIST OF LABORATORY EQUIPMENT AND MATERIALS)
sMPar³brikçaeRbIR)as;enAmnÞIrBiesaFn_ brimaN
Microscope binoculars 701 -Electric & solar light -Binocular head with 45o tilt and 360o rotation -Inter pupillary distance: 52-72mm -Dioptric adjustment of +/_ 5 dp in both eye pieces -Total magnification: 1600x -Condenser Abbe of 1.25 A.N -Power 200 volts-50Hz
01 set
Fridge -Capacity: 260 liters -Shelves: 4 -Height/width/depth (external): approx 130x60x60 cm -Power: 220 volts-50Hz
01
Bench centrifuge -Max, number of tube:10x10ml -Height/width/depth (external)cm: approx: 30x40x40
01
Vortex mixer for laboratory tubes -Diameter of tube: 7-30mm -Adjustable speed -Power: 220 volts-50Hz
01
RPR shaker -Macro-Vue card test with lid -Power: 220 volts-50Hz
01
Timer alarm “Relavis” -Time setting from 0 to 60 minutes in 01 minute interval
01
Slide forceps -Dissecting straight forceps round tips -Total length 180 mm
01
Scissor -Mini safety scissors -Total length 95 mm
01
Lamp Alcohol -Alcohol burner -Screw cap jar with wick
01
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 25 -
Rack for tube -Number of tube: 24 (8x3) -Tube diameter: 12mm
01
Wash bottle -Plastic bottle -Natural polyethylene -Curved tube -volume 250ml
01
Slide staining stand -Capacity 12-14 slides -stainless steel
01
Light bulb for microscope -Spare part for microscopic binocular 701 (3 light bulbs/microscope) -Halogen lamp 6V/20W
03
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
- 26 -
bBa¢IrayeQμaHbrikçaeRbIR)as;enAmnÞIrBiesaFn_ (LIST OF LABORATORY CONSUMABLE)
Pipette Pasteur disposable -Glass pipette Pasteur disposable -Volume 3ml, 150 mm length
100 (box)
RPR-nosticon -Macro-Vue RPR card test for detection of Syphillis -100 test/kits
01 kits
Immersion oil -Immersion oil microscopic 100ml
01 bottle
Potassium hydroxide (KOH) - Potassium hydroxide (250g)
01 bottle
Glass slides -Thin section slides of 26x76x1.5mm, Qty box of 100 slides
03 boxes
Cover slips -Cover slip of 18x18mm, Qty box of 100
02 boxes
Swab -Sterile cotton tipped applicators
200
Xylene -Cleaning solution
01 bottle
Methylene blue -Solution for staining of smears, volume: 100ml
03 bottles
Reagents for Gram Stain -Gram stains kit with reagents ready for use -Refill bottle for Gram stain (R1-R4) “Bio-Mérieux”
01 box
Vacutainer tube -Vacutainer tube 10ml (sterile) -Dry, for serum, qty box 0f 100
01 box
Vacutainer Needle -Vacutainer Needle: 21Gx1.5, 0.8x38mm (sterile) -Qty box 0f 100
01 box
- Vagina pH paper test 01 box
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
27
]bsm<n§½TI 7 KMrUr)aykarN_sMrab;eRbIR)as;enAKøInikkameraK
RbcaMEx ³ RtImasTI ³ qñaM 200>>>>
eQμaHKøInik ³ RsukRbtibtþi ³ extþ-Rkug³
ExTI 1 ExTI 2 ExTI 3cMnYnsrubénGñkCMgWbursEdl)anmkBinitü
cMnYnsrubénGñkCMgWRsIþEdlmankarRbQmmuxTab)anmkBinitü
cMnYnsrubénkarBinitüelIkdMbUgsMrab;RsIþrksIupøÚvePTedayRbeyal
cMnYnsrubénkarBinitütamdanbnþsMrab;RsIþrksIupøÚvePTedayRbeyal
cMnYnsrubénGñkCMgWRsIþrksIupøÚvePTedaypÞal;mkBinitüelIkdMbUg
cMnYnsrubénGñkCMgWRsIþrksIupøÚvePTedaypÞal;mkBinitütamdanbnþ
cMnYnsrubénWRsIþrksIupøÚvePTedaypÞal;EdlbBa¢ÚnmkedayRkumkargareRsamGnam½y100° cMnYnsrubénRsIþrksIupøÚvePTedayRbeyalEdlbBa¢ÚnmkedayRkumkargareRsamGnam½y100°
Gayu srub cegáameraKsBaØa <15 15-49 ≥ 50
burs ¬krNIfIμ¦ karhUrxÞúHtambgðÜrenam
dMe)AelIRbdab;bnþBUC
sirman;
epSg²
srubkrNIfI μénGñkCMgWburs
RsIþEdlmankarRbQmmuxTab ¬krNIfIμ¦ karFøak; s¼hUrxÞúHtamT§armas
rlakT§armas
rlakmat;s,Ún
rlakT§armas + rlakmat;s,Ún
rlakEb:lvIs (PID)
dMe)AelIRbdab;bnþBUC
sirman;
epSg²
srub
niyaménEbbbTsMrab;GnuvtþskmμPaB (SOPs) rbs;KøInikEfTaMnigBüa)alCMgWkameraK
28
éf¶>Ex>qñaM eFVIr)aykarN¾ >>>>>>>>>>>>>>>>>>¼>>>>>>>>>>>>>>>>>¼ 200>>>> eQμaH nightßelxaGñkeFVIr)aykaN¾ eQμaH nightßelxaRbFanKIønik
kMNt;sMKal; ³ DSW : Direct Sex Worker ¬RsþIrksuIpøÚvePTedaypÞal;¦ IDSW: Indirect Sex Worker ¬RsþIrksuIpøÚvePTedayRbeyal¦
PID: Pelvic Inflammatory Disease ¬rlakEb:lvIs¦
RsIþEdlRbQmmuxx<s; ¬krNIfIμ ¦<15 15-49 > 50 Total
DSW IDSW DSW IDSW DSW IDSW DSW IDSW
karFøak; s¼hUrxÞúHtamT§armas
rlakT§armas
rlakmat;s,Ún
rlakT§armas + rlakmat;s,Ún
rlakEb:lvIs (PID)
dMe)AelIRbdab;bnþBUC
sirman;
RPR + etsþviC¢man
epSg²
mkBin
itüelIk
dMbUg
srubkrNIf μ I mkBinitüelIkdMbUg
karFøak; s¼hUrxÞúHtamT§armas
rlakT§armas
rlakmat;s,Ún
rlakT§armas + rlakmat;s,Ún
rlakEb:lvIs (PID)
dMe)AelIRbdab;bnþBUC
sirman;
epSg²
mkBin
itütamd
anbnþ
srubkrNIf μ I mkBinitütamdanbnþ