ANNEXURE XII NATIONAL AIDS CONTROL PROGRAMME MONTHLY PROGRESS REPORT ON STDs These forms are subject to modification as per requirements arise time to time. State: Month: No. Of Reporting units No. Of units reported A: Diseases S. No. Diseases No. of cases detected In the month Cumulative M F Total M F Total 1. 1.1 1.2 1.3 1.4 Genital Ulcer Diseases Syphilis (early Primary) Chancroid Herpes genitals Donovanosis 2 Inguinal swelling - LGV 3 3.1 3.2 Urethal discharge Gonorrhoea Nongonococcal - urethritis 4. 4.1 4.2 4.3 4.4 Vaginal discharge Vaginitis Bacterial vaginosis Trichomonal vaginalis Candidiasis 4.5 4.6 4.7 Cervictis Gonococcal Chlamydial 5. Genital Warts (Candidiasis) 6. Genital Warts 7. Other types of syphilis Secondary Late cong 8. Scrotal swelling (epidiymoorchitis) -gonococcal & Cholamydial 9. Miscellaneous -Scabies Pediculosis 10. Total hospital new OPD Attendance B: Laboratory Investigations VDR/RPR A. Clam's Stain B. Partners Notification & Treatment D. Counselling S.No. Category of Patients No.of Samples Tested No. reactive % age related Month Cumulative Month Cumulative Month Cumulative 1. 1.1 1.2 Syphilis STD OPD Gynae. OPD/ANC No.of smear Collected No.Positive % age Positive Month Cumulative Month Cumulative Month Cumulative Gonorrhoea Wet Preparation (Koh/Saline) Bacterial Vaginosis (clue Cells) Candidiasis No.of vaginal smear Collected During month Cumulative Month Cumulative Month Cumulative Total number of STDs attended No.reported & Treated During month Cumulative Month Cumulative Month Cumulative Total number of STDs attended Condom advice And provision
