Pharmaceutical Sciences Notes

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Food Poisoning Disease Control and Prevention • Source Session/Topic 22 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 22: Identification of Patients with Food Poisoning Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Cause of Food Poisoning • Describe Mode of Transmission of Food Poisoning • Describe Major Signs and Symptoms of Food Poisoning • Explain Treatment of Food Poisoning • Explain Prevention and Control of Food Poisoning Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |15 minutes |Presentation |Cause of Food Poisoning | | | |Buzzing | | |3 |15 minutes |Presentation |Mode of Transmission of Food | | | |Brainstorming |Poisoning | |4 |15 minutes |Presentation |Major Signs and Symptoms of Food | | | | |Poisoning | |5 |15 minutes |Presentation |Treatment of Food Poisoning | |6 |40 minutes |Presentation |Prevention and Control of Food | | | |Small group |Poisoning | | | |Discussion | | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Food Poisoning (15 minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What causes food poisoning? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Definition Food poisoning is an acute intestinal disease acquired by consumption of contaminated food or water Causes Food poisoning can be divided into two categories: • Chemical (heavy metals, fluoride and others) • Infectious: Toxins produced by microorganism present in natural food or bacteria contaminating food or water o Infectious agents include viruses, bacteria, and parasites o Toxic agents include poisonous mushrooms, improperly prepared exotic foods Bacteria • Bacteria can cause food poisoning in two different ways o Some bacteria infect the intestines, causing inflammation and difficulty absorbing nutrients and water, leading to diarrhoea o Other bacteria produce chemicals in foods (known as toxins) that are poisonous to the human digestive system ▪ When eaten, these bacterial toxins can lead to nausea, vomiting, kidney failure, and even death • The common bacteria causing food poisoning are: ▪ Salmonellae, ▪ Campylobacter, ▪ Staphylococcus aureus ▪ Escherichia coli ▪ Clostridium botulinum ▪ Vibrio cholerae Pesticides • In food and naturally toxic substances like poisonous mushrooms or reef fish Viruses • These viruses include: o Noroviruses o Rotavirus o Enteroviruses o Hepatitis A Parasites • They are usually in contaminated or untreated water and cause long- lasting but mild symptoms o Examples of parasites which can cause illness are Giardia and Cryptosporidium Note: Toxic agents are the least common cause of food poisoning STEP 3: Mode of Transmission of Food Poisoning (15 minutes) |Activity: Brainstorming (15 minutes) | | | |ASK students to brainstorm on the following question: | | | |How is food poisoning transmitted? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | • Illness is often isolated episode caused by poor food preparation or selection o Eating wild toxic mushrooms, o Eating fish and other seafood that contains toxins o Eating food which has been contaminated with pesticides • Food poisoning illness usually arises from improper handling, preparation, or food storage • The illness is transmitted by undercooked foods such as eggs, potato, salads poultry, raw milk, dairy products, fish and other sea foods STEP 4: Signs and Symptoms of Food Poisoning (15 minutes) • Symptoms of food poisoning depend on the type of contaminant and the amount eaten • The symptoms can develop rapidly, within 30 minutes, or slowly, worsening over days to weeks • Most of the common signs and symptoms are: o Nausea, o Vomiting o Diarrhoea o Abdominal cramping • The incubation period is short depending on the cause of food poisoning: o Staphylococcal food poisoning takes 1 – 6 hours o Salmonella food poisoning takes 12 – 14 hours o Anthrax gastrointestinal poisoning take 2 – 5 days • There is acute onset of vomiting and diarrhoea after ingestion of contaminated food • Gastrointestinal anthrax presents with vomiting, abdominal pain, haematemesis, bloody diarrhoea and toxaemia • Staphylococcus aureus: Causes moderate to severe illness with rapid onset of nausea, severe vomiting, dizziness, and abdominal cramping • Clostridium botulinum (botulism): Causes severe illness affecting the nervous system o Symptoms start as blurred vision o The person then develops problems of talking and overall weakness o Symptoms then progress to difficulty breathing and inability to move arms or legs o Botulism has the 4 D’s: diplopia (double vision), dysphagia (difficulty swallowing), dysarthria/dysphonia (difficulty speaking) and diarrhoea • Neurological symptoms suggest insecticides e.g. organophosphorous or mushroom poisoning and seafood poisoning STEP 5: Treatment of Food Poisoning (15 minutes) • Symptomatic treatment to correct dehydration by ORS or intravenous fluid. o Helps to correct electrolyte imbalance that might arise from diarrhoea and vomiting o The patient may need to be admitted to the hospital ▪ This depends on the severity of the dehydration, response to therapy, and ability to drink

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Cholera Disease Control and Prevention • Source Session/Topic 23 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 23: Identification of Patients with Cholera Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Cause of Cholera • Describe Mode of Transmission of Cholera • Describe major Signs and Symptoms of Cholera • Explain Treatment of Common Cholera • Explain Prevention and Control of Cholera Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Causes of Cholera | | | |Buzzing | | |3 |40 minutes |Presentation |Mode of Transmission of Cholera | | | |Small group | | | | |Discussion | | |4 |10 minutes |Presentation |Major Signs and Symptoms of Cholera | | | |Brainstorming | | |5 |10 minutes |Presentation |Treatment of Cholera | |6 |30 minutes |Presentation |Prevention and Control of Cholera | | | |Small group | | | | |Discussion | | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Cholera (10 minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What causes cholera? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Definition • Cholera is acute diarrheal infection of the intestine caused by vibrio cholerae • The infection is often mild or without symptoms, but sometimes can be severe and fatal STEP 3: Mode of Transmission of Cholera (40 minutes) |Activity: Group discussion (30 minutes) | | | |DIVIDEstudents into small manageable groups | | | |ASK students to discuss on the following question | | | |How is cholera transmitted? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Transmission is through faecal –oral route but almost all cholera infections are water- borne (see figure 1). o Vibrio cholera can live in water for 2 weeks and prefer salty water o Vibrio may survive for longer period and multiply in shellfish The reservoir of infection is formed mainly by carriers excrete vibrio in small numbers posing danger to the community [pic] STEP 4: Signs and Symptoms of Cholera (10 minutes) |Activity: Brainstorming (15 minutes) | | | |Ask students to brainstorm on the following question: | | | |What are the signs and symptoms of cholera? | | | |ALLOW few students to respond? | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | • The incubation period is 2-3 days • The clinical presentation of cholera is caused by water and electrolyte loss and develop in 3 stages described below: First stage (last for 3-12 hours) • Characterized by passage of profuse watery stool • The stool comprises of clear fluid with flakes of mucous (rice water appearance) • vomiting • Severe cramps in the abdomen and limbs develop from loss of electrolytes Second stage: • There is collapse from dehydration • The body becomes cold, the skin dry and inelastic • The blood pressure is low and the pulse is rapid and feeble • Urine production stops and the patient may die of shock Third stage: • Stage of recovery, either spontaneously or with treatment • Diarrhoea decreases • Patient is able to take fluids and general condition improves STEP 5: Treatment of Cholera (10 minutes) • Patients should be hospitalised Rehydration • Cholera is cured by appropriate and timely rehydration o Patients of all ages who are strong enough to drink will take a lot of glucose/electrolyte solution needed for rehydration and maintenance • It is essential to use oral rehydration solution (ORS) or appropriate intravenous (IV) fluids to replace the necessary electrolytes. • Patients in shock or who are too weak to drink require intravenous fluids until they can take in oral fluids. Antimicrobials • Antimicrobial agents have been shown to shorten the period of diarrhoea and the amount of fluid loss o Tetracycline or doxycycline are the drugs of choice o Erythromycin is an effective alternative both in children and adults o Cotrimoxazole is also another alternative • Strict isolation is not necessary as only vomitus and stool are infectious • Patients are treated on ‘Cholera bed’ (beds with central hole) through which the continuous stool can pass into a bucket and fluid loss be measured [pic] STEP 6: Prevention and Control of Cholera (30minutes) |Activity: Group discussion (30 minutes) | | | |DIVIDEstudents into small manageable groups | | | |ASK students to discuss on the following question | | | |What are the prevention and control measures of cholera? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board |

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Ascariasis Disease Control and Prevention • Source Session/Topic 24 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 24: Identification of Patients with Ascariasis Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Causes of Ascariasis • Describe Mode of Transmission of Ascariasis • Describe Major Signs and Symptoms of Ascariasis • Explain Treatment of Ascariasis • Explain Prevention and Control of Ascariasis Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Cause(s) of Ascariasis | | | |Buzzing | | |3 |30 minutes |Presentation |Mode of Transmission of Ascariasis| | | |Small group | | | | |Discussion | | |4 |10 minutes |Presentation |Major Signs and Symptoms of | | | | |Ascariasis | |5 |10 minutes |Presentation |Treatment of Ascariasis | |6 |40 minutes |Presentation |Prevention and Control of | | | |Small group |Ascariasis | | | |Discussion | | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASKstudents to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Ascariasis (10 minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What causes Ascariasis? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Ascariasis: is one of the commonest infections of the small intestine • Caused by a nematode called Ascaris lumbricoides ( round worm) STEP 3: Mode of Transmission of Ascariasis (30 minutes) |Activity: Group discussion (30 minutes) | | | |DIVIDEstudents into small manageable groups | | | |ASK students to discuss on the following question | | | |What is the mode of transmission of Ascariasis? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Common ways of acquiring Ascariasis include failure to adhere to hygienic practices such as washing hands before food preparation and proper storage of food • Therefore the disease is related to poor sanitation and hygiene • Infection is acquired from ingestion of food contaminated with mature eggs • The usual vehicles are fruits and other raw food • Children are more frequently infected and have higher worm burden than adults because they like putting contaminated objects into their mouths • Heavy infection in children can contribute to under-nutrition • Adults have much lighter infections, although re-infection can occur throughout life [pic][pic]Refer students to Handout 24:1 Life cycle of ascaris lumbricoides for further reading STEP 4: Signs and Symptoms of Ascariasis (10 minutes) • Fever • Cough • Abdominal discomfort, restlessness and insomnia (sleeplessness) • Eosinophilia due to allergic reaction • Intestinal obstruction • Passing adult worm in the stool or vomitus • Obstructive jaundice STEP 5: Treatment of Ascariasis (10 minutes) • Treatment is effective only against the adult worms • The drugs of choice are as follows: o Albendazole: for children 2-5 years a single dose of 200mg and for older children and adults, one dose of 400mg is given o Mebendazole: a single dose 500mg o Levamisole: a single of 2.5mg/kg body weight o Piperazine (antepar): syrup at a dose of 150mg/kg body weight (to a maximum of 4g) as a single dose ▪ Note that these drugs are given between meals ▪ They should be avoided during the first tree monthsr of pregnancy STEP 6: Prevention and Control of Ascariasis (40 minutes) |Activity: Group discussion (30 minutes) | | | |DIVIDEstudents into small manageable groups | | | |ASK students to discuss on the following question | | | |How is Ascariasis transmitted? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Environmental measures such as provision of adequate and safe water supplies. • Proper disposal of faeces • prevention of faecal contamination of food and water • Discourage use of fresh human faeces as manure • Health education on: o Proper use of latrines o Personal hygiene e.g. washing hands after using toilet or before handling food o Washing fruits and vegetables before eating o Use of dry racks for utensils so that they are above the soil and dust STEP 7: Key Points (5 minutes) • Ascariasis is a common nematode infection. • The prevalence of Ascariasis is related to poor sanitation and hygiene • Control is mainly by improving faeces disposal • A heavy infection in a child can contribute to malnutrition STEP 8: Evaluation (5 minutes) • What is Ascariasis? • How does a person acquire Ascariasis infection? • What are the signs and symptoms of Ascariasis? • What is the treatment of Ascariasis? • What are preventive and control measures of Ascariasis? STEP 9: Assignment (5 minutes) |Activity: Take Home Assignment (10 minutes) | | | |DIVIDE

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Scabies Disease Control and Prevention • Source Session/Topic 25 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 25: Identification of Patients with Scabies Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Cause(s) of Scabies • Describe Mode of Transmission of Scabies • Describe Major Signs and Symptoms of Scabies • Explain Treatment of Scabies • Explain Prevention and Control of Scabies Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Cause(s) of Scabies | | | |Buzzing | | |3 |10 minutes |Presentation |Mode of Transmission of Scabies | |4 |30 minutes |Presentation |Major Signs and Symptoms of Scabies | | | |Brainstorming | | |5 |20 minutes |Presentation |Treatment of Scabies | |6 |30 minutes |Presentation |Prevention and Control of Scabies | | | |Small group | | | | |discussion | | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Titles and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Scabies(10 minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What causes scabies? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Scabies: A parasitic infection of the skin characterised by an intense itching with typical distribution caused by the mite Sarcoptes scabies • Prevalence is high in areas with shortage of water • Common in people who do not take bath regularly • Low socio-economic conditions favour the spread of the disease STEP 3: Mode of Transmission of Scabies (10 minutes) • Transmission is by direct close body contact from infected person and indirectly through bed clothes and sharing clothing • The female mite enters the skin and makes a small tunnel or burrow • The burrow is always superficial • The skin selected for burrow is always thin and wrinkled giving scabies rash a typical distribution • In the burrows, eggs and faeces are produced • The eggs hatch in 4-5 days • The larvae leave the parent tunnel and bury in the skin in other places, but do not make tunnels STEP 4: Signs and Symptoms of Scabies (30 minutes) |Activity: Brainstorming (10 minutes) | | | |Ask students to brainstorm on the following question: | | | |What are the signs and symptoms of scabies? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | • Intensive itching, especially at night • Eczema-like signs o The itching leading to scratching o Secondary bacterial infection • In case of immune suppression such as HIV and AIDS, infestation can be extensive • Typical distribution of severe itch and rash are: o Anterior axillary fold o Nipples, lower abdomen in women o Belt line (umbilicus) o Front side of wrist and elbows o External genitalia o Thighs and buttocks o Sides of fingers and toes o Sides and webs of fingers o Scalp and feet (infants under 1 year) • Patients with leprosy or other diseases which interfere with normal sensation may not feel the itching caused by scabies. In these cases, scabies can be very extensive and thick crusts can form [pic] STEP 5: Treatment of Scabies (30 minutes) • The drug of choice is 10% Benzyl benzoate emulsion (BBE) • Administration information o After the patient has taken a warm bath, the drug is applied over the whole body except the face o After 24 hours of first treatment, the patient should bath again and put on clean clothes o The drug has no effect on the eggs, therefore repeat BBE after 4 – 7 days to kill larvae which have hatched after the first treatment • Other drugs which can be used in the absence of BBE include: o Tetmosol solution or soap o Permethrin cream 5% (applied to areas of the body from neck downward and washed off after 8-14 hours) o Ivermectin 200µg/kg orally and repeated after 2 weeks or Lindane (1%) lotion or cream o Antibiotics are used only when there is a secondary infection (preferably Penicillin) STEP 6: Prevention and Control of Scabies (30 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | |What are the measures of preventing scabies? | | | |ALLOW students to discuss for 10 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |CLARIFY and SUMMARIZE by using the contents below | Prevention and control of scabies • Regular bathing with soap • Washing clothes regularly • Give health education to stress the use of soap and personal hygiene • Treat the whole family • Decontamination of bedding materials and clothing • Improve water supply STEP 7: Key Points (5 minutes) • Scabies is characterized by severe itching • It is treated with BBE, Tetmosol, Ivermectin or Lindane. • Treatment of scabies should include all

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Dermatophytes Disease Control and Prevention • Source Session/Topic 26 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 26: Identification of Patients with Dermatophytes Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Cause(s) of Dermatophytes • Describe Mode of Transmission of Dermatophytes • Describe Major Signs and Symptoms of Dermatophytes • Explain Treatment of Dermatophytes • Explain Prevention and Control of Dermatophytes Resources Needed • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Cause(s) of Dermatophytes | | | |Buzzing | | |3 |30 minutes |Presentation |Mode of Transmission of | | | |Small group |Dermatophytes | | | |discussion | | |4 |15 minutes |Presentation |Major Signs and Symptoms of | | | |Buzzing |Dermatophytes | |5 |15 minutes |Presentation |Treatment of Dermatophytes | |6 |30 minutes |Presentation |Prevention and Control of | | | |Small group |Dermatophytes | | | |discussion | | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Dermatophytes (10 minutes) Definition • Dermatomycosis is a term applied to fungal infection of the skin and its appendages i.e. hair and nails o Different types are identified according to causative organism, site and clinical appearance o They are sometimes indicators of immune suppression as occurs in AIDS, cancer, diabetes and tuberculosis. Types of dermatomycosis • Tinea capitis (ringworm of the scalp) • Tinea corporis (ringworm of the body) • Tinea pedis (ringworm of the foot or ‘athlete’s foot’) • Tinea unguium (ringworm of the nails) • Tinea versicolor or pityriasis STEP 3: Mode of Transmission of Dermatophytes (30 minutes) |Activity: Group discussion (20 minutes) | | | |DIVIDEstudents into small manageable groups | | | |ASK students to discuss on the following question | | | |What is the mode of transmission of dermatophytes? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • All fungi may be transmitted to humans by direct skin contact from their habitat in the soil, vegetation, animals or other individuals • Genital infection (balanitis and vulvo-vaginitis) may spread during sexual intercourse but most candida infections are not sexually transmitted • Local conditions on the skin such as moist and hot environment are predisposing factors [pic] STEP 4: Signs and Symptoms of Dermatophytes (15 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What are the signs and symptoms of dermatomycosis? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Tinea Capitis (Ringworm of the scalp) • Begins as a small papule which spreads to involve a larger area • Hairs in the affected skin become brittle and break off easily • Occurs mainly in children under 10 years and often disappears after puberty Tinea Corporis (Ringworm of the body) • Characterized by flat ring shaped spreading lesions • The ring lesions are reddish, vesicular or pastula, and may be dry and scaly, or moist and crusted • The central area often clears leaving apparently normal skin Tinea Pedis (Ringworm of the foot or athlete’s foot) • Characterized by scaling and cracking of the skin between the toes, particularly the fourth and fifth toes Tinea Unguium (Ringworm of the nails) • Characterized by a thickening, discolouration and brittleness of the nails • There is accumulation of caseous materials beneath the nail which becomes chalky and disintegrates Tinea Versicolor or Pityriasis • This is a very superficial infection • Skin on side of face, neck and chest show many irregular, round and light- coloured areas STEP 5: Treatment of Dermatophytes (15 minutes) Tinea Capitis • Griseofulvin is the drug of choice, although oral therapy with itraconazole and terbinafine are effective alternatives. • Oral fluconazole seems to have similar efficacy to Griseofulvin • Give Griseofulvin at a dosage of 250 mg twice a day or 500mg once a day in adults and 20-25mg/kg for children for 6-12 weeks • Whitefield’s ointment applied twice daily for 3 – 6 weeks has also been used in areas where the above drugs are not available. Tinea Corporis • This responds well with application of topical antifungal such as Clotrimazole 1% cream, lotion or solution (use twice daily), and ketoconazole 2% cream (used once daily) • Severe disease and disease in immune compromised patients should be treated with systemic agents Tinea Cruris • Topical antifungal treatment should be used (just as in Tinea corporis) • Resistant lesions can be treated with griseofulvin or other systemic agents • Patients should be advised to dry the area completely after bath and not to wear tight clothing Tinea Pedis • Topical agents applied for duration of 4 weeks are usually effective • Chronic or extensive disease may require o Griseofulvin 250 – 500mg twice daily for 6 – 12 weeks, or o Terbinafine 250 mg daily or itraconazole

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with HIV/AIDS Disease Control and Prevention • Source Session/Topic 27 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 27: Identification of Patients with HIV/AIDS Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Causes of HIV/AIDS • Describe Mode of Transmission of HIV/AIDS • Describe Major Signs and Symptoms of HIV/AIDS • Explain Treatment of HIV/AIDS • Explain prevention and control of HIV/AIDS Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Causes of HIV/AIDS | | | |Buzzing | | |3 |30 minutes |Presentation |Mode of Transmission of HIV/AIDS | | | |Small group | | | | |discussion | | |4 |10 minutes |Presentation |Major Signs and Symptoms of HIV/AIDS| | | |Brainstorming | | |5 |10 minutes |Presentation |Treatment of HIV/AIDS | |6 | 40 minutes|Presentation |Prevention and Control of HIV/AIDS | | | |Small group | | | | |discussion | | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of HIV/AIDS (10 minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What causes HIV/AIDS? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Human Immunodeficiency Virus (HIV) infection: • State of being infected with the Human Immunodeficiency Virus without showing signs and symptoms Acquired Immunodeficiency Syndrome (AIDS) • A state of being HIV infected with presentation of signs and symptoms STEP 3: Mode of Transmission of HIV/AIDS (30 minutes) |Activity: Group discussion (30 minutes) | | | |DIVIDEstudents into small manageable groups | | | |ASK students to discuss on the following question | | | |What is the mode of transmission of HIV? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Unprotected sexual intercourse with infected partner • Vertical transmission: o During pregnancy o During delivery o During breast feeding • Contact with infected blood products • Transfused with infected blood • Injection drug use (IDU) through needle-sharing, needle stick accidents, unsterilized needles. Factors influencing transmission of HIV/AIDS • Risky sexual behaviour e.g. unsafe sex with infected partner and multiple sexual partners • Social economic e.g. commercial sex • Cultural practices e.g. female genital mutilation • Biological e.g. young age and early sexual indulgence • Political e.g. war and political instability • Unsterile procedures e.g. sharing instruments for circumcision • Peer pressure towards involvement into sexual intercourse • Substance abuse e.g. cocaine, bhang, heroine and alcohol [pic][pic]Handout 27.1: Life cycle of HIV for further reading STEP 4: Signs and Symptoms of HIV/AIDS (10 minutes) |Activity: Brainstorming (5 minutes) | | | |Ask students to brainstorm on the following question: | | | |What is the signs and symptoms of HIV/AIDS? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | Signs and symptoms of HIV infection: • Fever • Headache • Cough • Lymphadenopathy • Skin rashes, which resolve spontaneously • Mental illness (dementia) The natural history of HIV can be explained in different stages or clinical presentation • Acute HIV infection (window period): can present as any acute viral illness o HIV antibodies take time to be produced and show up on a blood test o Window period is the period between time of infection and hen initial detection of HIV antibodies is possible by laboratory tests o People who test HIV negative must be tested again after 3 months, when antibodies should have developed o DNA/RNA testing can be used to diagnose HIV infection before antibodies are formed • Latent HIV infection o This is a period when the patient has no symptoms at all o The body is still able to fight against most of the diseases just as in HIV negative individuals o Patient may have generalized lymphadenopathy • Late stages of HIV infection o The immunity of the patient falls and severe life threatening infections occur e.g. cryptococcal meningitis, toxoplasmosis and pneumocystis pneumonia STEP 5: Treatment of HIV/AIDS: (10 minutes) • Not all HIV positive patients are eligible for treatment withARVs • Two classes of patients eligible to begin treatment: o All patients in WHO stage 3 and 4 clinical criteria, regardless of CD4 cell count. o All adolescences and adults including pregnant women with a CD4 count < 350cells/mm3, regardless of clinical symptoms • Nucleoside Reverse Transcriptase Inhibitors (NRTIs) o Zidovudine (AZT) o Lamivudine (3TC) o Abacavir (ABC) o Emtricitabine (FTC) o Stavudine (d4T) • Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) o Nevirapine (NVP) o Efavirenz (EFV) • Nucleotide Reverse Transcriptase Inhibitors (Nucleotide Analogues) o An example of this relatively new class of antiretroviral drugs is Tenofovir (TDF) • Protease Inhibitors (PIs) o Lopinavir (LPV) o Atazanavir (ATV) • Antiretroviral therapy involves the

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Tuberculosis Disease Control and Prevention • Source Session/Topic 28 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 28: Identification of Patients with Tuberculosis Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Causes of Tuberculosis • Describe mode of Transmission of Tuberculosis • Describe Major Signs and Symptoms of Tuberculosis • Explain Treatment of Tuberculosis • Explain Prevention and Control of Tuberculosis Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Causes of Tuberculosis | | | |Buzzing | | |3 |30 minutes |Presentation |Mode of Transmission ofTuberculosis | | | |Small group | | | | |Discussion | | |4 |10 minutes |Presentation |Major signs and Symptoms of | | | |Brainstorming |Tuberculosis | |5 |10 minutes |Presentation |Treatment of Tuberculosis | |6 |40 minutes |Presentation |Prevention and Control of | | | |Small group |Tuberculosis | | | |Discussion | | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Tuberculosis (10 minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What causes tuberculosis? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Definition • Tuberculosis (TB) is a chronic infectious disease caused mainly by mycobacterium tuberculosis (M. tuberculosis) and occasionally by mycobacterium bovis or mycobacterium africanum. Tuberculosis can be grouped into two main types: Pulmonary tuberculosis (PTB) • Affects the lungs • Most common and accounts for 80% of all cases of TB Extra-pulmonary (EPTB) • Affects organs other than the lungs • Non-infectious • Accounts for 20% of all cases of TB • The most common types of extra-pulmonary tuberculosis are: o TB lymphadenitis o TB of the bones and joints o TB meningitis • Tuberculosis is on the increase, especially in countries with high prevalence of HIV • Tuberculosis can kill or render the patient disabled for life if untreated or inadequately treated STEP 3: Mode of Transmission of Tuberculosis (30 minutes) |Activity: Group discussion (30 minutes) | | | |DIVIDEstudents into small manageable groups | | | |ASK students to discuss on the following question | | | |What is the mode of transmission of tuberculosis? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • The transmission of tubercle bacilli occurs by airborne spread of infectious droplets • TB is transmitted from one person to another through inhalation of droplets during: o Coughing o Laughing o Talking o Sneezing o Spitting o Singing • Coughing is the common means of transmission • The risk of acquiring the infection is higher for individuals close to the patient • Direct sunlight kills tubercle bacilli within minutes, but they can survive in the dark for many hours (24-48 hours) Note: The majority (90%) of people without HIV infected with mycobacterium tuberculosis do not develop tuberculosis because their immune system is strong enough to prevent the development of tuberculosis STEP 4: Signs and Symptoms of Tuberculosis (10 minutes) The most common symptoms of pulmonary tuberculosis are: • Persistent cough for 2 weeks or more • Blood stained sputum (haemoptysis) • Shortness of breath • Chest pain • Fatigue (tiredness) • General malaise • Loss of appetite • Loss of weight • Night sweats • Fever The symptoms for extra-pulmonary tuberculosis depend on the organs involved, for example: • Chest pain in Tb pleurisy • Swelling of lymph nodes in Tb lymphadenitis • Pain and swelling of joints in Tb arthritis • Deformity of the spine (Pott’s disease) • Headache, fever, stiffness of the neck and mental confusion in Tb meningitis STEP 5: Treatment of Tuberculosis (10 minutes) Treatment is divided into three groups: • New patients who have no history of TB treatment or who have received less than one month of anti-TB drugs regardless of their smear or culture results • Previously treated patients who have received anti-TB drugs for one month or more in the past with a second episode • Drug-resistant patients with tubercle bacilli that are resistant to rifampicin and isoniazid Direct observation treatment (DOT) strategy • Direct observation treatment means that a trained health care provider or other designated individual, including family members, observe the patient swallow all tablets • Ensures that a TB patient takes the right drugs, in the right doses, at the right intervals and finishes treatment within the required duration, There are five essential first-line anti-TB drugs for adults and children in Tanzania, as recommended by the MOHSW and WHO. • Drugs are formulated in fixed drug combinations (FDCs) o Isoniazid (H) o Rifampicin (R) o Pyrazinamide (Z) o Ethambutol (E) o Streptomycin (S) • Treatment of TB requires multiple drugs for effectiveness o This is called Multi-Drug Treatment (MDT) o If one or two drugs are used alone, other organisms will not be

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Leprosy Disease Control and Prevention • Source Session/Topic 29 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 29: Identification of Patients with Leprosy Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Cause(S) of Leprosy • Describe Mode of Transmission of Leprosy • Describe Major Signs and Symptoms of Leprosy • Explain Treatment of Leprosy • Explain Prevention and Control of Leprosy Resources Needed • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |15 minutes |Presentation |Cause(s) of Leprosy | |3 |20 minutes |Presentation |Mode of Transmission of Leprosy| | | |Brainstorming | | |4 |30 minutes |Presentation |Major Signs and Symptoms of | | | |Small group |Leprosy | | | |discussion | | |5 |15 minutes |Presentation |Treatment of Leprosy | |6 |20 minutes |Presentation |Prevention and Control of | | | |Brainstorming |Leprosy | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Leprosy (15minutes) • Leprosy is a chronic infectious disease caused by mycobacterium leprae (M. leprae) • Mainly affects the skin, peripheral nerves, and mucous membranes • The disease affects people of all ages and sexes STEP 3: Mode of Transmission of Leprosy (15 minutes) |Activity: Brainstorming (5 minutes) | | | |ASK students to brainstorm on the following question: | | | |What is the mode of transmission of leprosy? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | • Leprosy bacilli are mainly transmitted through infectious droplets that are spread by an infectious individual through coughing and sneezing • Patients carrying many leprosy bacilli are called multibacillary (MB) patients o They are the main source of infection • Individuals with few bacilli in their body are called paucibacillary (PB) o They are not a significant source of infection • Healthy carriers are people carrying the bacilli without developing the disease o They are not a significant source of infection • Skin contact with leprosy patients not a means of transmitting leprosy infection • Leprosy has a very long incubation period of 3-30 years, with an average of five years STEP 4: Sign and Symptoms of Leprosy (20minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What are the signs and symptoms of leprosy? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • One or more pale or reddish, hypo-pigmented patch(es) on the skin with diminished or loss of sensation • Painless swelling or lumps in the face and/or earlobes • Enlarged and/or tender nerves • Burning sensation of the skin • Numbness or tingling of hands and/or feet • Weakness of eyelids, hands, and/or feet • Painless wounds or burns on the hands and/or feet • The skin lesion can be single or multiple and in many cases less pigmented than the surrounding skin. Sometimes lesion is reddish or copper-coloured • The skin lesion may show loss of sensation on light touch, a key feature in leprosy • Lesions can present in different ways, but macules (flat), papules (raised) or sometimes nodules are the most common STEP 5: Treatment of Leprosy (30 minutes) • The aim of leprosy control is to: o Cure patients o Detect and treat leprosy reactions o Prevent further damage to nerves and other tissue in patients with an already existing disability o Prevent further transmission to other community members • Multi Drug Treatment (MDT) is the only adequate chemotherapy that will kill bacilli • MDT is a combination of a minimum of two anti-leprosy drugs, prescribed in the correct dosage, taken regularly for a period of 6-12 months • Multi bacillary (MB) patients are treated for a period of 12 months • Paucibacillary (PB) patients are treated for 6 months • Treatment of leprosy with only one drug will result in development of drug-resistance • Treatment is given according to WHO recommended MDT regimens based on the • classification of Multibacillary or Paucibacillary • The patient receives a combination of rifampicin, dapsone and clofazimin in case of MB or rifampicin and dapsone in case of PB • The patient should thus attend the nearest clinic where she/he is registered to collect • blister pack and for clinical assessment. • The patient takes the first dose under direct observation of a health worker • In the following 27 days the patient then takes the medicine without being supervised by the health worker [pic] STEP 6: Prevention and Control of Leprosy ( 15 minutes) • Early diagnosis and prompt treatment with Multi Drug Therapy o Case holding and patient compliance o Early detection of leprosy reactions and prompt treatment with prednisolone to prevent disabilities STEP 6: Key Points (20 minutes) • Leprosy is a chronic infectious disease caused by Mycobacterium leprae • The cardinal signs are skin lesion with loss of sensation, one or more enlarged peripheral nerves and a positive skin smear. • Treatment is given according

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Gonorrhoea Disease Control and Prevention • Source Session/Topic 30 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 30: Identification of Patients with Gonorrhoea Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Causes of Gonorrhoea • Describe Mode of Transmission of Gonorrhoea • Describe Major Signs and Symptoms of Gonorrhoea • Explain Treatment of Gonorrhoea • Explain Prevention and Control of Gonorrhoea Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |15 minutes |Presentation |Causes of Gonorrhoea | | | |Brainstorming | | |3 |15 minutes |Presentation |Mode of Transmission of Gonorrhoea | |4 |30 minutes |Presentation |Major Signs and Symptoms of | | | |Small group |Gonorrhoea | | | |discussion | | |5 |20 minutes |Presentation |Treatment of Gonorrhoea | |6 |20 minutes |Presentation |Prevention and Control of | | | | |Gonorrhoea | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Gonorrhoea (15 minutes) |Activity: Brainstorming (5 minutes) | | | |ASK students to brainstorm on the following question: | | | |What is Gonorrhoea? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | • Gonorrhea is an acute or chronic purulent infection of the urogenital tract caused by gonococcus is known as Neisseria gonorrhoeae • Gonorrhea is by far the commonest of so called ‘classical STIs’ known before the • emergence of HIV and AIDS all over the world • Gonorrhea can cause sterility in both males and females and accounts for a serious • decline in birth rate in some communities • The Gonococcus is not able to penetrate intact skin or squamous epithelium but prefers columnar epithelium such as in the urethra, endocervix, rectum and conjunctiva STEP 3: Mode of Transmission of Gonorrhoea (15 minutes) • Gonorrhoea is mainly transmitted through sexual intercourse, o However, there are exceptions e.g. gonorrheal ophthalmia neonatorum is an acute inflammation of the conjunctiva of the new born, contacted during passage through the birth canal of an infected mother STEP 4: Signs and Symptoms of Gonorrhoea (30 minutes) |Activity: Group discussion (15 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | | | |What are the signs and symptoms of gonorrhoea? | | | |ALLOW students to discuss for 10 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | The signs and symptoms may differ between men to females as follows; In males • The earliest symptom is irritation at the urinary meatus o After an incubation period of 2 – 10 days, symptoms of urethritis develop in majority of infected men • A burning sensation when passing urine • A purulent yellow and profuse discharge soon follow • Dysuria (difficult in passing urine) may be slight or very severe • Severe dysuria is often accompanied by urgency and frequency and occasionally • Terminal haematuria (blood in urine) • In untreated cases, the discharge which was purulent and profuse gradually become o Scant and less purulent discharges may present only in the mornings In females • About 50 -80% of infected women have no symptoms • Urethritis and discharge often may go unnoticed • Cervicitis may cause a discharge • Most of symptoms in females are due to complications of gonorrhoea • The risk of infection after a single exposure to an infected partner ranges from 20 to 35% in male and from 60 to 90% in females STEP 5: Treatment of Gonorrhoea (20 minutes) • The recommended first line drugs for treatment of Gonorrhoea include the following: o Ceftriaxone o Norfloxacin o Ciprofloxacin • The recommended alternative or second line drugs for treatment of Gonorrhoea include the following: o Cefixime o Cefoxitin o Cefotaxime o Spectinomycin (Togamycin) o Azithromycin o Cotrimoxazole • Treatment of Ophthalmia neonatorum include: o Gentamycin and Kanamycin o Gentamicin can be available in form of eye drops o Zinnat syrup (oral cephalosporin-cefuroxime) o The eyes should be washed with saline 2 hourly for the first 12 hours and subsequently every 4 hours STEP 6: Prevention and Control of Gonorrhoea (20 minutes) • Abstinence • Avoid multiple partners and stick to one uninfected partner • Proper and consistent use of condom • Early diagnosis and treatment is important to reduce/prevent complications and further spread of infection among the community • Partners must be treated regardless of their symptoms or test results • Health education on public awareness and specific knowledge of STIs in the target groups STEP 7: Key Points (5 minutes) • Gonorrhoea is a common STI in the community which needs prompt diagnosis and treatment STEP 8: Evaluation (5 minutes) • What is Gonorrhoea? • What are signs and symptoms of gonorrhea? • What is mode of transmission of gonorrhea? • What is the treatment of gonorrhea? • How can you prevent Gonorrhoea in the community? STEP 9: Assignment (5 minutes) |Activity: Take Home Assignment (5 minutes) | | | |ASK the students to

NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Syphilis Disease Control and Prevention • Source Session/Topic 31 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 31: Identification of Patients with Syphilis Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Describe Causes of Syphilis • Describe Mode of Transmission of Syphilis • Describe Major Signs and Symptoms of Syphilis • Explain Treatment of Syphilis • Explain Prevention and Control of Syphilis Resources Needed • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers • Computer and LCD Projector SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |5 minutes |Presentation |Cause(s) of Syphilis | |3 |15 minutes |Presentation |Mode of Transmission of Syphilis | | | |Buzzing | | |4 |40 minutes |Presentation |Major Signs and Symptoms of Syphilis| | | |Small group | | | | |discussion | | |5 |10 minutes |Presentation |Treatment of Syphilis | |6 |30 minutes |Presentation |Prevention and control of Syphilis | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Syphilis (5minutes) • Syphilis: A chronic multi-systemic disease caused by the bacteria spirochetal bacterium Treponema pallidum. STEP 3: Mode of Transmission of Syphilis (15 minutes) |Activity: Buzzing (10 minutes) | | | |ASK students to pair up and buzz on the following question for 2 | |minutes | | | |What is the mode of transmission of Syphilis? | | | |ALLOW few pairs to respond and let other pairs to add on points not | |mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • The spirochaete Treponema pallidum enters the body through mucous membranes and skin. • The route of transmission of syphilis is almost always through sexual contact, although there are other routes such as: o Congenital Syphilis via transmission from mother to child in utero. o Transfusion of unscreened blood. o A patient with secondary syphilis who has mucosal or cutaneous lesion may transmit the disease through physical contact. o Unusual but possible transmission is accidental contact with infective tissue. STEP 4: Signs and Symptoms of Syphilis (40 minutes) |Activity: Group discussion (20 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | | | |What are the signs and symptoms of Syphilis? | | | |ALLOW students to discuss for 10 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | There are 3 main stages of the disease namely: • Primary Syphilis • Secondary Syphilis • Tertiary Syphilis Note: Different manifestations occur depending on the stage of the disease; as outlined below: Primary Syphilis • Primary syphilis is typically acquired via direct sexual contact with the infectious lesions of a person with syphilis. • Approximately 10-90 days after the initial exposure (average 21 days), a skin lesion appears at the point of contact, which is usually the genitalia, but can be anywhere on the body o This lesion, called a chancre which is a firm, painless skin ulceration localized at the point of initial exposure to the spirochete, often on the penis, vagina, rectum or elsewhere like lips, tongue, breast etc. • The lesion may persist for 4 to 6 weeks and usually heals spontaneously. • Local lymph node swelling can occur. [pic] Secondary Syphilis • Secondary syphilis occurs approximately 1–6 months (commonly 6 to 8 weeks) after the primary infection. • There are many different manifestations of secondary disease. • A patient with syphilis is most contagious when he or she has secondary syphilis. • There may be a symmetrical reddish pink non-itchy rash on the trunk and extremities. • This is accompanied with mild constitutional systems, often described as flu-like. • These rashes tend to be symmetrical can involve the palms of the hands and the soles of the feet. • In moist areas of the body such as anus, vulva, perineum, mouth, and axilla the rash becomes flat, broad, whitish lesions known as condylomata lata. • All of these lesions are infectious and harbor active treponema organisms. Tertiary Syphilis • Tertiary syphilis usually occurs 1–10 years after the initial infection, though in some • Cases it can take up to 50 years. • This stage is characterized by the formation of gummas which are soft, tumor-like lesions of inflammation known as granulomas. • They may appear almost anywhere in the body including the skeleton and brain. • The more severe manifestations include neurosyphilis and cardiovascular syphilis • The incubation period of syphilis varies from 10 days to 10 weeks with average of 3 weeks. STEP 5: Treatment of Syphilis (10 minutes) • The drug of choice is intramuscular Benzathine benzylpenicillin • Doxycycline • Erythromycin STEP 6: Prevention and Control of Syphilis (30 minutes) |Activity: Group discussion (15 minutes) | | | |DIVIDE students into small manageable groups | | | |ASK students to discuss on the following question | | | |What are the prevention and control measures of Syphilis? | | | |ALLOW students to discuss for 10 minutes | | | |ALLOW few groups to present and the rest to add points not mentioned | | | |WRITE their response on