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Kerala State AIDS Control Society, Thiruvananthapuram. Training of Medical and Paramedical Staff on HIV/AIDS/STI Prevention & Control Training Status as on 31st August, 2000

Particulars	State level trainers	District level trainers	No. trained in Medical Colleges				No. trained in Dist./PHC
			Doctors	Nurses	Auxiliary Staff	Others (specify)	Doctors	Nurses	Others (specify)
Nos. trained during year 1999-2000	33	81	76						2000 (Jr.PHN) 2000 (Jr.H.I)
No.trained during 2000-2001(upto August 2000)		16
Cumulative		97
No. to be trained (total strength)							1500	5250(Staff Nurses) 6000(Jr.PHN)	5700 (Nursing.Assistants) 600 0(HA)

STD Control Programme
National STD Control Programme in India was started in 1946. With the arrival spread of HIV infection in the country it was brought under the purview of National AIDS Organization in the year 1992.

Objectives of STD Control Programme
1. Reduce STD cases and thereby control HIV transmission by minimizing the risk factor
2. Prevent the short term as well as long term morbidity and mortality due to STD
In order to accomplish these objectives; following strategies have been incorporated in the strategic plan for the prevention and control of AIDS in India.
Strategies
The broad strategies for controlling STD, as outlined in the strategic plan for the prevention and control of AIDS in India are the following:

Adequate and effective programme management
Prevention of the transmission of STD/HIV infection through IEC and promotion of safer sexual behaviour by the use of condoms.
Adequate and comprehensive case management including diagnosis, treatment, individual counseling, partner notification and screening for other diseases.
Increasing access to health care for STD by strengthening existing facilities and structures and creating new facilities wherever necessary.
Early diagnosis and treatment of mostly asymptomatic infections through case finding and screening.

Actions

The following major actions have been taken along the lines suggested in the strategies.

o Training of health care workers in both public and private sectors in comprehensive STD case management.

o Development of appropriate laboratory services for the diagnosis of STD

o Conduct of Microbiological, Socio-behavioural and Operation research.

o Surveillance to assess the epidemiological situation, and monitor and evaluate the on going STD control programme.

One of the major actions taken along the lines suggested in the strategies was strengthening the existing facilities and structure of STD clinics.

Accordingly there are 20 STD clinics in 14 districts in Kerala identified by NACO.

List of STD Clinics (identified by NACO)

Sl.No	District	Name of Hospital
1	Thiruvananthapuram	1. MCH Thiruvananthapuram 2. General Hospital 3. THQH Nedumangad
2	Kollam	4. District Hospital, Kollam
3	Pathanamthitta	5. General Hospital
4.	Alappuzha	6. MCH Alappuzha 7. District Hospital, Alappuzha
5	Kottayam	8. MCH Kottayam
6	Idukki	9. THQH Thodupuzha
7	Ernakulam	10. General Hospital, Ernakulam
8	Thrissur	11. MC Chest Hospital, Thrissur 12. District Hospital, Thrissur
9	Palakkad	13. District Hospital, Palakkad
10	Malappuram	14. District Hospital, Manjeri
11	Kozhikode	15. MCH Kozhikode 16. General Hospital,Kozhikode
12	Wayanad	17. Dist. Hospital, Mananthawady
13	Kannur	18. Dist. Hospital, Kannur 19. General Hospital, Thalassery
14	Kasargod	20. Dist. Hospital Kanjangad

Out of 20 clinics 16 are provided with counselors by Kerala State AIDS Control Society. Every month reports are received from these clinics regarding the number of various STDs and monthly reports are sent to NACO from Kerala State AIDS Control Society. Medicines and consumables required for these clinics are purchased by Kerala State AIDS Control Society and supplied to them according to NACO guidelines.

A “Control Strategy Planning Workshop on STD” was conducted on the 12^th and 13^th of April 2000 in Thiruvananthapuram which was attended by eminent STD specialists from Tamil Nadu and various Medical Colleges in Kerala. Following were the recommendations made during the concluding session.

1.       To keep the confidentiality of the STD patients seeking treatment adequate privacy should be provided in the clinics.
2.       Training of doctors – clinical training for doctors from peripheries in the teaching institutions.
3.       Adequate laboratory facilities and drugs for treating STDs

An orientation programme for counselors from STD clinics was conducted on the 13^th October, 2000 at the conference hall of Kerala State AIDS Control Society. During the programme they were given directions on proper reporting of cases, conduct tracing and basics of different STDs.

This year following drugs are supplied by KSACS to the STD clinics other than the usual.

Erythromycin 500 mg Tabs.
Doxycycline caps 100 mg
Norfloxacin 400 mg Tabs
Fluconazole 150 mg tabs
Clotrimzole Vag Tab 500 mg
Acyclovir cream 5 mg tubes

Consumables like disposable syringes and examination gloves will also be supplied.

Some of the NGOs in their projects have arranged centres and facilities for diagnosis and treatment of STDs seen in people with high risk behaviour. Technical and financial assistance for this is given by Kerala State AIDS Control Society.

Action Plan

With the technical and financial assistance from Family Health International Kerala State AIDS Control Society will be conducting a prevalence survey of STDs among female CSWs in three districts namely Kozhikode, Thrissur and Thiruvananthapuram.
Various NGOs are organising workshops on STDs for the practicing doctors in their respective project areas to make them more familiar with syndromic and etiological management of STDs. Technical assistance will be given from KSACS.
It has been proposed to conduct a study on CSWs regarding the prevalence of HSV II infection among them by doing antibody tests IGG & IGM.