RksYgsuxaPi)al

niyamEbbbTsMrab;eFVIetsþRsavRCav rkemeraKsVaycMeBaHRsþImanépÞeBaH

enARBHraCaNacRkkm<úCa

qñaM 2008

‐ 2 ‐ 

 

ffl1fu~mjjliV5~!ibtl6,"u~

ui1rMJD ibmu"leJ

iJfl~aV~~161e un" ~fi ... ...

~,sm~sm~!,~e~~luum

t'lJtmnm~Btlf'ia~tHU1l~ltrUJt'i:f[ll~lutll HttrtmQrum~lmlrgB~~EtHrj~ tidtnlJf'i B~f'i1mn~ B~

HttrHUQru~l~mmrH1m B~91rf'i trlBnltllf'i1rlli1~~eic!1g~l'i;!mB~1rj~HfHIDB~~:nfttrlru ~l~tnlnlH~f'i1rHBtHEl

r~lfttrlru ujuii tnlG~lb1~1BBm1HtUUUgMmh~tei~ln111lm11f'it'i:fm~~mfhm{u1ttj'lB1~H'mtSilom~l =~= =::~.:.._~;~:_~=~:~

llil1Glf'if'iW~l t~tUtlUltil~~ltmruf'i1nUilH1BHttrHUQru~1~gi~rir MnUH~1~trrgnlll~m~~8mb1U~~~ B~

~8mb1~hfi9 q~f'i1rgu'1fliif'i1riiru~t'i:fm~~lmri~mt94ljBlUf'imrjlmlmtl~mb1~~ mnBt94~uutrlii~E

~mriFhlliiei iitmg911f'itB4q~lb1m~lllil1Glf'if'i~mB1mruHB1~ei ~

- m­

‐ 4 ‐ 

 

Uit1Jl::l~31ihrmrUlsg~ru~rnm mm~Hmurul::lmml:i'!Jlmtisrmmiijseiulm9ffirl1Jmql::lUtllillHm9

ffirlSlSltSur~Mlm~Ulft~2ffirlt1~QUBl::l~2ffirl~fUigtsilmgMii~UltsiifJ [)ooe>-[)OCiJO '1 mm~f~2 v ,

ur~MlU'~mfttsg rnfmmmrummn Bl::lm~mmJltUrultU1JmUl~Bt3ld t~HjtmmtMntj}m~2ffirlmm

mtUd~ f;~tim~Bii~2ffirlmtUH~mdHStHSd~fimruH~f~lt1iimt3lmlt1fij~ffirl~tUMHlMt1t9iBl::l~Sffirl . t1~t1j~tmMfl~2ffirlh:lrumSlMlUBl::lf;~l::l~truhmnsiql::llmgMii~m '1

liit1Jl::l~31fimru tcljmfim Bcnuiuuu9Mntil§u'~tCU11W11lnlumr:tr!1uD'nuT1lt~tr1Bl~UT1nB1n~th

tsgeiUltIiiMld§rJ31B1Jt1H9j~ rJnUHrn~31fimrutt:lruf;~l::lUUmdl::llnsimHtMfltj}m~2ffirlt1~QUBl::l~2

ffirl~fUi9 mi1tMMtMfltj}mt~tmnrsmrurJnrutsimHHU!Jru~2ffirl Bl::lH~nrlgJt1t~ii lrlHml::l~Bii~2

ffirlt1~QUtSH~mdHstHSd~fimru tlUlmtUm~ru~sl~gtSmd~ruJHUtlliliigU~~mdurul::lmml:i'!Jlmti

srmtmijs t~Hjrunstm~t1um~nE'!Jlmtif;tllil~utmgmmtsi!'1l::llrlgnUlllilltiliiii~mSltrlruHSlI:i~ '1 , ,

ql::lamMtSg ~tiJHt~l::l~fmnm~MtMdt:lrnHIDHU!Jrumftml::ltid lrlHml::ltt:l~Hfifm2~31fimruml::lHtUtt:lru

mSa~8lfil::ltlt1l::lMtnmnut1Utmf1jmSmBli1lHtt1t1t1grJnUH~f~mngm~lMlflmfdiimml:i'!Jlmutmg

u~mSt~tmgtsilmgMii~m '1

- r: ­

‐ 6 ‐ 

 

HIDtHl~rum~lurrr~£h:H~EtHt:lfii nlitfiUFi BilmHtllf.'i Bil HIDH(l!Jrum~mmHmi1 Bil911Fi ftJH1YilHlliu

~llilrihillmru\ltti ihmmmFi-mnFiUUmilHnllt:lrum fUm~Fi-fUm~mlSmHmrillmr~m9fUMl1tlmr I I

utru Billtlmt1j1Ulrumm~tllf.'irnHmr!Hu'i9 BillUt:l1ITU~~~ It:lruUlSH\~Q)Hfit1HIDHUQrum~lurrr~Bil I·

~E\Ht:lfii nlitfUJFi Bilmmnf.'i. HIDHUQrum~mmrmrn Bil91rFi. 19J1tj!lSm~f1?8mt1nnl:i1rllil:. nBfi

f1?8mt1fU~H. H~mr RHAC, RACHA, FHI, PSF, PSI, MEC, Marie Stapes, US-CDC, UNFPA,

WHO, CHAI, UN ICEF Bil19j1tj!lS ITM It:lruUls~ru!Hijlllilfi\uuijBllilHluUU9MnIT\~m~lnnjlmj

1Fimtllf.'irgJmij\mgl~msl~\mm:liFiwm '1

BmlH1UUU9\Sg fimtJ fi nn r~~ t:l1 rlt:l rums nnr: M81S MnITH~ j~1 ti nn l~81ilHlhsg lUfimt:l1m~llilmt1 Bil

lUw~mt1~nl '1

-t1l­

‐ 8 ‐ 

 

‐ 9 ‐ 

 

1 esckþIepþIm eTaHbICasBVéf¶enH manbec©kviTüaevC¢saRsþy:agTUlMTUlaysMrab;kareFVIeraKvinicä½y nigBüa)alkarbgáeraKsVay cMeBaHRsþImanépÞeBaHk¾eday CMgWsVayenAEtCabBaðacMbgénsuxPaBsaFarN³ CaBiessplvi)akdl;TarkeBlmun nigeRkaykMeNIt enARbeTsCaeRcInelIBiPBelak. eK)an):an;sμanfa 2PaK3énRsþImanépÞeBaHEdlmanCMgW sVaydMNak;kaldMbUgehIymin)anTTYlkarBüa)al GacnwwgvivtþeTArkkarrlUtkUn/ kUnekItmksøab; bJuk¾karbgáeraK cMeBaHkUnEdleTIbnwgekIt. tamkarGegátRsavRCavGRtaeRbv:aLg;énkarqøgemeraKsVay ¬edayeFVIetsþ RPR nigbBa¢ak;lT§pledayetsþ TPHA ¦ cMeBaHRsþImanépÞeBaHEdl)anmkBinitüsuxPaBenAesvaBinitüépÞeBaH )anbgðajfa RsþImanépÞeBaH 4>0° enAqñaM 1996 nig 0>7° enAqñaM 2001 manemeraKsVay. k¾b:uEnþrhUtmkdl;bc©úb,nñenH BMuTan;manr)aykarN_ NamYysþIBIkrNICMgWsVayBIkMeNItcMeBaHTark enAkñúgRbBn½§Bt’manénRksYgsuxaPi)alenAeLIyeT. mUlehtuenH bNþaleGaymankarlM)akkñúgkarkMNt;eGay)anc,as;fa etICMgWsVayBIkMeNItenARbeTskm<úCa CabBaðaF¶n;F¶rb:H Bal;dl;suxPaBTarkkMritNa?. eTaHbICaCMgWsVay CaCMgWEdlbgáplvi)aky:agF¶n;F¶rdl;RsþImanépÞeBaH nigTark EdleTIbnwgekItk¾eday k¾CMgWenHgayRsYlnwgbgáarNas; tamviFIsaRsþRKb;RKgEfTaMBüa)alCMgWkameraKEdlGac Gnuvtþ)anenARbeTskm<úCa. eKalneya)ay nigyuT§saRsþCatisþIBIkarbgáar nigEfTaMBüa)alkarbgáeraKtamkarrYmePT qñaM 2006-2010 ¬eKalneya)ayTI 8¦)anbB©ÚalnUvyuT§saRsþénkarykcitþTukdak;CaBiessrbs;RksYgsuxaPi)al cMeBaHsuxPaB RsþImanépÞeBaHnigTarkeTIbnwgekItEdlGacRbQmmuxnwgkarbgáeraKtamkarrYmePTnigRbdab;bnþBUC. yuT§saRsþCatisþIBIsuxPaBpøÚvePTnigsuxPaBbnþBUC/ qñaM2006-2010 k¾)ankMNt;fa CMgWenARbdab;bnþBUC ¬rYm TaMgCMgWkameraK¦ KWCaEpñkd¾sMxan;mYyénkmμviFIsuxPaBbnþBUCenARbeTskm<úCaeyIg.

2 eKalbMNgrYm eKalbMNgrYménkareFVIetsþRsavRCavrkemeraKsVaycMeBaHRsþImanépÞeBaHKW edIm,IkMcat;CMgWsVayBIkMeNItcMeBaH TarkEdleTIbnwgekItTaMgGs;enARbeTskm<úCa.

‐ 10 ‐ 

 

3 TisedAsMxan;² TisedAsMxan;KW karbgáarkarcMlgemeraKsVayBImþayeTAkUn edayepþateTAelITisedABiessmYycMnYn dUcxag eRkamenH ³

3>1 kMNt;eraKvinicä½yénetsþesr:UsaRsþ viC¢man cMeBaHRsþImanépÞeBaH 3>2 Büa)alRsþImanépÞeBaH ¬mþay¦ nigédKU edIm,Ikat;bnßykarcMlgeraK 3>3 Büa)alnigtamdansuxPaBTark

niyamEbbbTsMrab;karGnuvtþn_enH k¾manbB©ÚalpgEdrnUvkarBinitütamdanGMBIRbsiT§iPaBénkarEfTaMBüa)al cMeBaHmþaypgEdr.

4 yuT§saRsþ 4>1 kMNt;eraKvinicä½yénetsþesr:UsaRsþviC¢mancMeBaHRsþImanépÞeBaH

• Gñkpþl;esvaEfTaMsuxPaBenAEpñkBinitüépÞeBaHmuneBlsMralénmNÐlsuxPaB/ mnÞIreBTübEg¥k nigKøInik GgÁkarminEmnrdæaPi)alTaMgGs; RtUvCMrujelIkTwkcitþdl;RsþIeGayeFVIetsþRsavRCavrkemeraKsVay )an y:agticNas;k¾mYydgEdr kñúgeBlmanépÞeBaH. RsþImanépÞeBaHTaMgGs; RtUveFVIetsþRsavRCavrkemeraK sVayenAeBlmkBinitüelIkdMbUg bJueGay)ankan;Etqab;kñúgeBlmanépÞeBaH RbsinebIGaceFVIeTA)an. RbsinebIRsþIenaHmin)aneFVIetsþ kñúgeBlmanépÞeBaHeT Kat;RtUveFVIetsþenH enAeBlsMralkUn.

• etsþrh½s (Rapid test) “Bioline” sMrab;RsavRCavrkemeraKsVay (Treponema-specific rapid

diagnosis test) RtUv)ankMNt;eGayeRbIsMrab;eFVIetsþRsavRCavrkemeraKsVay cMeBaHRsþIEdlman épÞeBaH CaBiessenAeBlEdlKat;mkBinitüsuxPaBenAEpñkBinitüépÞeBaH BIeRBaHGñkpþl;esvaGaceRbI etsþenH)anrh½s nig gayRsYlCagetsþRbePTdéTeTot.

• eTaHbIy:agNak¾eday Rapid test enHminGackMNt;)anfa CMgWsVayenaHeTIbEtqøgfμ I bJuqøgyUrNas; mkehIy bJuk¾CaCMgWsVayEdl)anTTYlkarBüa)al bJuminTan;Büa)aleT. dUecñHeKRtUvykesr:UmQamGñk CMgWEdlmanlT§pl Rapid test viC¢manenaH bBa¢ÚneTAkan;mnÞIrBiesaFn_ edIm,IeFVIetsþ RPR EbbKuN PaB (qualitative test) bBa¢ak;elIlT§pl Rapid test bEnßmeTot. lT§pletsþ RPR enHGac

‐ 11 ‐ 

 

bBa¢ak;fa CMgWsVayenaHCaCMgWEdleTIbqøgfμ I² nigminTan;TTYlkarBüa)alenAeLIy dUecñHRtUvpþl;kar Büa)alCUnGñkCMgWenaH.

• RtUvGb;rMENnaMdl;RsþITaMgGs;EdlmanlT§pletsþCMgWsVayviC¢man edayetsþRbePTNak¾eday eGay eTAmNÐlpþl;RbwkSaeFVIetsþQamrkemeraKeGds_edaysμ ½RKcitþ nigrkSakarsMgat; bJubUmQamKat;Edl )ansμR½KcitþeFVIetsþQamrkemeraKeGds_ ehIybBa¢ÚnsMNakQameTAesvaeFVIetsþ HIV.

4>1>1 CMhannanasMrab;kareFVIetsþRsavRCavrkemeraKsVaycMeBaHRsþImanépÞeBaH enAesvaBinitüépÞeBaH 4>1>1>1 CMhanTI 1³

• RsþImanépÞeBaHmkTTYlesvaBinitüépÞeBaHCaelIkdMbUg • pþl;Bt’mansþIBIsar³RbeyaCn_énkareFVIetsþRsavRCavrkemeraKsVaycMeBaHRsþImanépÞeBaH • BinitürkemIldMe)AbJuBgEbkelIRbdab;bnþBUC ³

• RbsinebImandMe)A bJuBgEbkelIRbdab;bnþBUC RtUveFVIeraKvinicä½ynigBüa)alGñkCMgW eTAtamKMnUsbMRBYjéneKalkarN_ENnaMCati ¬sUmemIl]bsm<½n§TI 9 nig eKal karN_ENnaMCatisþIBIkarRKb;RKgEfTaMBüa)alkarbgáeraKtamkarrYmePT nigRbdab; bnþBUC¦

• RbsinebIKμandMe)A bJuBgEbkelIRbdab;bnþBUCeT RtUvbnþeTACMh‘anTI2 edIm,IRsav RCavrkemeraKsVayeday Rapid test .

4>1>1>2 CMhanTI 2³ • eCaHykQamBIcugRmaméd • eFVIetsþrkemeraKsVayedayeRbIetsþ Treponema-specific rapid diagnosis test

(RDT) “Bioline” ¬sUmemIl]bsm<½n§TI3¦³ • RbsinebIlT§pletsþ GviC¢man enaHbBa¢ak;faRsþIenaHKμanqøgemeraKsVayeT.

dUecñHRtUvGb;rM nigpþl;RbwkSadl;Kat; CaBiesskarGb;rMGMBIkareRbIR)as;nigpþl; eRsamGnam½yedIm,ICameFüa)ayrYmsMrab;bgáarkarqøgemeraKeGds_¼kameraK

‐ 12 ‐ 

 

nigkarmanépÞeBaH. CaTIbBa©b; RtUvpþl;Bt’manGMBIkarpþl;RbwkSanigeFVIetsþQam rkemeraKeGds_.

• RbsinebIlT§pletsþ viC¢man RtUvbnþeTACMh‘anTI3 edIm,IeFVIetsþ RPR (qualitative) sMrab;bBa¢ak;eGaydwgfa CaCMgWsVayEdleTIbnwgqøgfμ I².

• kMNt;cMNaM ³ lT§plén Rapid test RtUvkt;RtaTukenAkñúgbBa¢IBinitüépÞeBaH (Antenatal

register) ¬sUmemIl]bsm<½n§TI4¦

4>1>1>3 CMhanTI 3³ • bUmQamcMnYn 5 m>l> dak;eTAkñúgbMBg;TIb ¬Edls¶Ütnig)ansMlab;emeraK¦ bnÞab;mkyk

KMrbmkRKbeGayCit ehIybBa¢ÚneTAmnÞIrBiesaFn_edIm,IeFVIetsþ RPR (qualitative). lTVpletsþRtUvpþl;CUnGñkCMgWeGay)anqab;.

• RbsinebIlTVpletsþ GviC¢man enaHGacbBa¢ak;)anfa CMgWsVayEdl)anrkeXIj KW CaCMgWsVayEdlekItmanBImunmknig)anTTYlkarBüa)alrYcehIy. RtUvGb;rM nig pþl;RbwkSadl;Kat; CaBiesskarGb;rMGMBIkareRbIR)as;nigpþl;eRsamGnam½yedIm,I CameFüa)ayrYmsMrab;bgáarkarqøgemeraKeGds_¼kameraK nigkarmanépÞeBaH. CaTIbBa©b; RtUvpþl;Bt’manGMBIkarpþl;RbwkSanigeFVIetsþQam rkemeraKeGds_.

• RbsinebIlTVpletsþ viC¢man bBa¢ak;faCMgWsVayenaHeTIbEtqøgfμ μ I² ehIyGacmin Tan;)anTTYlkarBüa)alenAeLIy. dUecñHRtUv ³

• Büa)alCMgWsVay ¬sUmemIl]bsm<½n§TI1¦ CUnGñkCMgW nigGb;rM -pþl;RbwkSadl;Kat; CaBiesskarGb;rMGMBIkareRbIR)as;nigpþl; eRsamGnam½yedIm,I CameFüa)ayrYmsMrab;bgáarkarqøgemeraK eGds_¼kameraK nigkarmanépÞeBaH. CaTIbBa©b; RtUvpþl;Bt’man GMBIkarpþl;RbwkSanigeFVIetsþQamrkemeraKeGds_.

‐ 13 ‐ 

 

• kMNt;cMNaM ³ lT§plénetsþ RPR (qualitative) RtUvkt;RtaTukenAkñúgbBa¢IBinitüépÞeBaH (Antenatal register) ¬sUmemIl]bsm<½n§TI4¦.

4>1>2 kareFVIetsþRsavRCavrkemeraKsVaycMeBaHRsþImanépÞeBaH enAesvasMralkUn • RsþImanépÞeBaHTaMgGs;RtUveFVIetsþRsavRCavrkCMgWsVayenAesvasMralkUn RbsinebIRsþIenaHminTan;)aneFVI

etsþenHkñúgkMlugeBlmanépÞeBaH ehIyKat;minTan;QWeBaHsMralkUnenAeLIy. • dMeNIrkarénkareFVIetsþRsavRCav nigBüa)alCMgWsVayenAesvasMralkUn KWdUcKñanwgdMeNIrkarenAesva

BinitüépÞeBaHmuneBlsMralEdr. 4>2 karRKb;RKgBüa)almþay nigédKUrYmePTrbs;Kat;edIm,Ikat;bnßykarcMlgemeraKsVay

4>2>1 karBüa)alcMeBaHmþay 4>2>1>1 eBlevlaénkarBüa)al ³

- RtUvBüa)almþayPøam² bnÞab;BIkarbBa¢ak;edayetsþ RPR (qualitative) bgðaj lT§pl viC¢man CaBiesskarBüa)alenH Kb,Ipþl;edaymRnþIsuxaPi)alenAEpñkBinitü épÞeBaHmuneBlsMral (ANC service).

- RtUvsaksYrGñkCMgWGMBIRbvtþiRbtikmμCamYy»sf munnwgpþl;karBüa)alCUnKat; ¬sUm emIl]bsm<½n§TI8¦

4>2>1>2 »sfsMrab;Büa)al ³ - RtUveRbI»sf Benzathine Penicillin G 2.4 million unit cak;sac;dMuEtmþgKt;

cMeBaHRsþImanépÞeBaHTaMgGs;EdlK μaneraKsBaØab:uEnþmanlT§pletsþ RPR viC¢man. cMeBaHRsþIEdlmanCMgWsVaydMNak;kaldMbUg ¬mandMe)AelIRbdab;bnþBUC¦ nigCMgWsVay dMNak;kalTIBIr RtUvBüa)altamrUbmnþdUcKñaenHEdrenH.

krNIRbtikmμCamYyBBYk»sf Penicillin ³ - RtUveRbI»sf Erythromycin 500mg elb bYndgkñúg1éf¶ ry³eBl 14 éf¶.

‐ 14 ‐ 

 

kMNt;cMNaM ³ - cMeBaHRsþIEdlpÞúkemeraKeGds_ ³ RKUeBTüCMnajxøH)anpþl;Gnusasn_eGayeRbI»sf

Benzathine-Penicillin G 2.4 million units cak;sac;dMu mYydgkñúgmYys)þah_ ry³eBlbIs)þah_bnþbnÞab;Kña edaymankarBinitütamdaneGay)anhμt;ct;enAesva EfTaMBüa)alCMgWeGds_. dUecñH vamansar³sMxan;Nas;EdlRtUvbBa¢ÚnRsþImanépÞeBaHpÞúk emeraKeGds_ eTATTYlkarEfTaMBüa)alenAesvaEfTaMBüa)alCMgWeGds_ ehIyRtUvCUn Bt’manGMBIlT§pletsþesrU:saRsþCMgWsVay viC¢man dl;Gñkpþl;esvaenATIenaHpg.

4>2>2 karGeBa¢IjédKUeGaymkBüa)al • RtUvBinitütamdannigGeBa¢IjédKUrYmePTrbs;RsþImanépÞeBaHehIyqøgemeraKsVayeGaymkTTYlkarEfTaM

Büa)al • RtUvBüa)alCMgWsVayCUndl;édKUrYmePTTaMgGs;enaH enAeBldMNalKñaCamYyRsþImanépÞeBaHEtmþg Rbsin

ebIGaceFVIeTA)an edayeRbI»sf Benzathine-Penicillin G 2.4 million units cak;sac;dMu EtmþgKt;. kñúgkrNIEdlGñkCMgWenaHRbtikm μCamYyBBYk Penicillin RtUveRbI»sf Erythromycin 500mg elbbYn dgkñúgmYyéf¶ ry³eBl 14éf¶ bJu »sf Doxycycline 100mg elbBIrdgkñúgmYyéf¶ ry³eBl 14éf¶.

• RtUvGb;rMdl;édKUrYmePTrbs;RsþIEdlmanlT§pletsþsVayviC¢man eGayeTATTYlesvaenAmNÐlpþl; RbwkSa nigeFVIetsþQamrkemeraKeGds_edays μR½Kcitþ nigrkSakarsMgat; (VCCT).

4>2>3 karBinitütamdancMeBaHmþay 4>2>3>1 eRkayBIlT§pl Rapid test nigetsþ RPR qualitative viC¢man ³

- eRkayBIlT§pletsþ RPR qualitative viC¢man RtUvykKMrUQamdEdlenaHeTAeFVI etsþ RPR quantitative (RPR titre). bnÞab;mk RtUvkt;RtalT§pletsþ RPR

titre enAkñúgesovePAbBa¢IBinitüépÞeBaHmuneBlsMral “ Antenatal record ” ¬sUm emIl]bsm<n§½TI5¦ nigesovePAsuxPaBmata “ Mother Health’s Record book ” ¬sUmemIl]bsm<n§½TI6¦ edIm,IrkSalT§pletsþ RPR titre enaHCaeKal (baseline)

‐ 15 ‐ 

 

sMrab;eRbobeFoblT§plBinitütamdanRbsiT§iPaBénkarBüa)al enAeBlEdlRsþICa mþaymkBinitüsuxPaBelIkeRkay²eTot.

4>2>3>2 eRkayBImþay)anTTYlkarBüa)alCMgWsVay ¬sUmemIl]bsm<n§½TI2¦ ³

- RtUvR)ab;eGayRsþIEdlmanetsþCMgWsVay viC¢man enaH RtLb;mkCYbGñkvij ry³eBlBI 6 eTA 12Ex eRkayBIKat;)anTTYlkarBüa)al edIm,IBinitütamdanRbsiT§iPaBénkar Büa)al edaykareFVIetsþ RPR quantitative (RPR titre) sareLIgvij. Cakar RbesIr mþayKb,IRtLb;mkBinitütamdaneLIgvijenAExTI9 eBlEdlKat;ykkUnmk cak;fñaMbgáarCMgWkRBa¢il.

- Kb,IeFVIetsþ RPR quantitative (RPR titre) enAmnÞIrBiesaFn_dEdl ¬mnÞIrBiesaFn_ Edlmþay)aneFVIetsþenHBIelIkmun¦. RbsinebImankarERbRbYllT§pl titre 4dg enAcenøaHl,ayetsþBIr (two dilutions) ¬]> BI 1³16 eTA 1³4 bJu BI 1³8 eTA 1³32¦ enaHGacbBa¢ak;c,as;fa mankarERbRbYllT§plrvagetsþBIr EdlrkemeraK sVay edayeRbIR)as;RbePTetsþEtmYyRbePTdUcKña ³ • RbsinebIlT§pl RPR titre fycuH 2dgbJuelIsBI2dg ¬]> BI 1³16 eTA 1³4¦

bJu lT§pletsþ RPR qualitative GviC¢man RtUvGb;rMnigpþl;RbwkSadl;Kat; Ca BiesskarGb;rMGMBIkareRbIR)as; nigpþl;eRsamGnam½yedIm,ICameFüa)ayrYmsMrab; bgáarkarqøgemeraKeGds_¼kameraK nigkarmanépÞeBaH ehIyRtUvGeBa¢IjédKUrbs; Kat;eGaymkTTYlkarBüa)al RbsinebIédKUenaHminTan;)anTTYlkarBüa)alenA eLIy nigpþl;Bt’mandl;Kat;nigédKUrbs;Kat;GMBIkarpþl;RbwkSanigeFVIetsþQamrk emeraKeGds_ RbsinebIKat;TaMgBIrnak;min)aneFVIetsþenHkalBIeBlmkBinitüépÞ eBaHmuneBlsMral bJuRbsinebIKat;mankarRbQmmuxnwgkarqøgemeraKeGds_ ebI eTaHbICalT§pletsþEdl)aneFVIBIelIkmun²GviC¢mank¾eday.

‐ 16 ‐ 

 

• RbsinebIlT§pl RPR titre KμankarfycuH4dgeT eRkayBIkarBüa)alCMgWsVay Gs;ry³eBl6Exmk ¬]> eRbobeFobCamYynwglT§pl RPR titre Edl)aneFVI kalBIelIkdMbUgenAeBlcab;epþImBüa)al¦ enaHGacbBa¢ak;)anfa karBüa)alGac braC½y bJuCMgWsVayenaHCaCMgWsVayEdl)anqøgyUrNas;mkehIy ¬qøgelIsBI 2qñaM¦ bJuk¾GacqøgCMgWsVaysarCafμ ImþgeTot. eTaHbIy:agNak¾eday lT§pletsþ esr:UsaRsþEbbenH minGacbBa¢ak;BImUlehtuNamYyEdl)anerobrab;enHeGay)an BitR)akd)aneT. dUecñH RtUvBüa)alCMgWsVayCUnGñkCMgWenHsarCafμ I nigeFVIetsþrk emeraKeGds_sarCafμ I ¬kñúgkrNIlT§pletsþelIkmun GviC¢man¦. ebIeTaHbICa karBüa)alCMgWsVayEdlqøgfμ I RtUveRbIR)as;»sf Benzathine-Penicillin G

2.4 million units cak;sac;dMuEtmþgKt;;k¾eday RKUeBTüKb,Ipþl;karBüa)alCUnGñk CMgWEdlmansßanPaBEbbenH eday»sf Benzathine-Penicillin G 2.4

million units cak;sac;dMu mYydgkñúgmYys)þah_ ry³eBlbIs)þah_bnþbnÞab;Kña edIm,IeGaykarBüa)alenHGacmanRbsiT§iPaBcMeBaHCMgWsVayEdl)anqøgyUrNas;mkehIy nigCMgWsVayEdl)anBüa)albraC½yBIelIkmun.

• kMNt;sMKal; ³ CaTUeTA etsþ RPR qualitative RtLb;eTACa GviC¢man vij eRkayBIkarBüa)alTTYl)aneCaKC½y k¾b:uEnþcMeBaHGñkCMgWxøH RPR titre Gacsßit enAkñúgkMritTabGs;ry³eBld¾yUr bJuCYnkalGs;mYyCIvit.

4>3 karBüa)al nigkarBinitütamdancMeBaHTark 4>3>1 kareFVIeraKvinicä½yCMgWsVayBIkMeNItcMeBaHTarkEdleTIbnwgekItenAesvasMralkUn

• kareFVIeraKvinicä½yCMgWsVayBIkMeNItmankarlM)aksμ úksμajNas; edaysarEtkarepÞrGgÁbdibkçR)aN BImþaymkTarktamry³suk (transplacental transfer of maternal antibodies to the

fetus) . karepÞrGgÁbdibkçR)aNBImþayeTAkUnenH eFVIeGaymankarlM)akkñúgkarbkRsaylT§pl etsþesr:UsaRsþcMeBaHCMgWsVayelITarkEdleTIbnwgekIt. eyIgk¾minRtUvykQamBITgsukTarkeTA

‐ 17 ‐ 

 

eFVIetsþEdr edaysarQamenaHGacnwgmanqøgemeraKsVayBIQamrbs;mþay. dUecñHKμanetsþNa mYysMrab;eRbIR)as;RsavRCavrkemeraKsVayBIkMeNItcMeBaHTarkenAeLIyeT. kareFVIeraKvinicä½yCMgW enHBwgEp¥keTAelIkarBinitüeraKsBaØaKøInik nigRbvtþiCMgWnigkarBüa)alrbs;mþay.

• RtUvBinitüeGay)anhμt;ct;cMeBaHTarkEdleTIbnwgekIt edIm,IrkeraKsBaØaEdlGacsgS½yfaCa CMgW sVayBIkMeNIt ³

- RbsinebImaneraKsBaØaNamYyxageRkamenH sUmbBa¢ÚnTarkeTAesvaÉkeTsEfTaMBüa)al kumar bJumnIÞreBTübEg¥kNamYy ³

• TarkekItminRKb;Ex bJuTarkekItmkmanTMgn;ticCagFm μta • manhUrsMe)ar bJuTwkrégBIRcmuHruaMér: • sm,úrelOg ¬PñasesImenAEPñkelOg¦ • eføIm/ GeNþIk bJukUnkNþúrrIkFM • knÞÜlrmas;Es,k CYnkalEs,ks¶Üt bJumanBgTwktUc² bJuEbkRska

bJuesIm² CaBiessenAéd/ eCIg bJuenAbrievNCMuvijmat; bJurn§KUf • RTg;RTayq¥wgenARcmuH bJueCIgmanlkçN³minFmμta-evoc.

- ebIeTaHbICaTarkEdleTIbnwgekItKμaneraKsBaØaNamYyxagelIenHk¾eday b:uEnþTarkenaHekIt ecjBImþayEdlmanetsþsVay viC¢man eyIgRtUvEtBüa)alCMgWsVaycMeBaHTarkeday»sf

Benzathine-Penicillin cak;sac;dMuEtmþgKt;. • bnÞab;mk RtUvbBa¢ÚnTarkeTAesvacak;fñaMbgáar nigeFVIetsþ DNA-PCR rkemeraKeGds_.

4>3>2 karBüa)alCMgWsVaycMeBaHTarkEdleTIbnwgekIt

• RtUvBüa)alCMgWsVayeday»sf Benzathine-Penicillin G 50,000 units/Kg. cak;sac;dMuEt mþgKt; cMeBaHTarkEdleTIbnwgekItecjBImþayEdlmanetsþemeraKsVay viC¢man ebIeTaHbICaTark EdleTIbnwgekItenaH K μaneraKsBaØaCMgWsVayBIkMeNItk¾eday.

‐ 18 ‐ 

 

4>3>3 karBinitütamdankumar • eTaHbICaTarkqøgemeraKsVayBImþay ehIyKμaneraKsBaØaenAeBleTIbnwgekItk¾eday k¾eraKsBaØa

KøInikénCMgWsVayBIkMeNItGacnwgelcecjenAeBleRkaymkeTot. • dUecñH ral;eBlEdlmþaynaMkumarmkTTYlkarcak;fñaMbgáar ¬s)aþh_TI 6/ 10/ 14 nigenAExTI 9¦

RKUeBTüRtUvBinitükumarrkeraKsBaØaKøInikénCMgWsVayBIkMeNItdUcCa ³ manhUrsMe)ar bJuTwkrégBIRcmuH ruaMér:/ sm,úrelOg ¬PñasesImenAEPñkelOg¦/ eføIm/ GeNþIk bJukUnkNþúrrIkFM/ knÞÜlrmas;Es,k CYnkalEs,ks¶Üt bJumanBgTwktUc² bJuEbkRska bJuesIm² CaBiessenAéd/ eCIg bJuenAbrievNCMuvij mat; bJurn§KUf. RbsinebImaneraKsBaØaNamYy RtUvbBa¢ÚnkumareTAesvaÉkeTsEfTaMBüa)alkumar bJu mnÞIreBTübEg¥kEdlenACitbMput edIm,IeFVIkarvaytMéleraKvinicä½yCabnÞan;nigTTYlkarBüa)alPøam².

• kMNt;cMNaM ³ edIm,ICYysMrYldl;karBinitütamdankumarnigmþay Gñkpþl;esvaEfTaMsuxPaBenAesva sMralkUn nigesvacak;fñaMbgáarRtUvsresrkMNt;cMNaM “mþay RPR (+) nigkumar)anTTYlkar Büa)alehIy” enAelIb½NÑcak;fñaMbgáar edIm,IeGayGñkpþl;esvaBinitütamdanrkeraKsBaØaKøInik erogral;eBlEdlkumarmkcak;fñaMbgáar nigedIm,IeFVIetsþ RPR titre cMeBaHmþayeLIgvijenAExTI 9 eBlmþaynaMkUnmkcak;fñaMbgáarCMgWkRBa¢il.

5 karpÁt;pÁg;sMPar³ brikçar nigRbtikr

sMPar³sMrab;eFVIetsþ RPR nwgRtUv)anpÁt;pÁg;CUndl;mnÞIrBiesaFn_énmnÞIreBTübEg¥k nigGtItmnÞIreBTüRsuk tam ry³mCÄmNÐlCatiRbyuT§nwgCMgWeGds_ esIEs,k nigkameraK/ mCÄmNÐlCatiKaMBarmata nigTark nigtamry³ GgÁkarGnþrCati-GgÁkarminEmnrdæaPi)alCaédKU. RksYgsuxaPi)alnwgpÁt;pÁg;»sf brikçar nigRbtikr (Rapid

test “Bioline”, RPR test) tamry³XøaMg»sfkNþalCUndl;kariyal½ysuxaPi)alRsukRbtibtþi edIm,IEckcay bnþ. »sf brikçar nigRbtikrmYycMnYnsmRsbRtUv)anrkSaTukenAkñúgXøaMgsþúkénmCÄmNÐlCatiRbyuT§nwgCMgWeGds_ esIEs,k nigkameraK sMrab;karpÁt;pÁg;CabnÞan; kñúgkrNImankarekIneLIgnUvtMrUvkar bJukardac;sþúk Cayfaehtu kñúgcenøaHeBlénkarpÁt;pÁg;edayXøaMg»sfkNþal.

‐ 19 ‐ 

 

6 karpSBVpSayBt’man/ Gb;rM nigTMnak;TMng erogral;eBlBinitüCMgW Gñkpþl;esvaEfTaMRtUvGb;rMGtifiCnGMBIkarbgáarCMgWkameraK-eGds_ nigkareFVIetsþrk

emeraKeGds_/ bgðajR)ab;GMBIrebobeRbIR)as;eRsamGnam½y/ R)ab;GMBIkareRbIR)as;»sfeGay)anRtwmRtUv-eTogTat; nigCab;lab; nigR)ab;GMBIkarGeBa¢IjédKUrYmePTeGaymkTTYlkarEfTaMBüa)al.

7 karBinitütamdan nigr)aykarN_

7>1 bBa¢IsMrg;Bt’manGtifiCnBinitüépÞeBaHmuneBlsMral ¬ ]bsm<n§½TI4¦ • RtUveRbIR)as;bBa¢IsMrg;Bt’manGtifiCnBinitüépÞeBaHmuneBlsMral EdlkMBugeRbIR)as;enAtammNÐlsux

PaB/ mnÞIreBTübEg¥k nigKøInikGgÁkarminEmnrdæaPi)aledIm,Ikt;RtaBt’mansegçbrbs;RsþImanépÞeBaH enA ral;eBlKat;eTABinitüsuxPaB.

• cMeBaHesvasuxaPi)alenAtamRsukRbtibtþiEdlkMBugGnuvtþyuT§saRsþénkareqøIytbrYmKña cMeBaHkarbgáar nigEfTaMBüa)alCMgWeGds_-kameraK nigsuxPaBbnþBUC (Linked Response for Prevention, Care,

and Treatment of HIV/AIDS and Sexual and Reproductive Health Issues) RtUveRbIR)as; esovePAcuHbBa¢IRsþImanépÞeBaHEdlsμR½KcitþTTYlkarpþl;RbwkSanigeFVIetsþQamrkemeraKeGds_ enAEpñk BinitüépÞeBaH Edl)anpþl;CUnedaymCÄmNÐlCatiRbyuT§nwgCMgWeGds_ esIEs,k nigkameraK.

• bBa©ÚlbEnßmxÞg; (column) cMnYnbYn ³ “eFVIetsþrkemeraKsVayeday Rapid test niglT§pletsþ”

nig “eFVIetsþrkemeraKsVayeday RPR test niglT§pletsþ” eTAkñúgbBa¢IsMrg;Bt’manGtifiCn Binitü épÞeBaHmuneBlsMral ¬sUmemIl]bsm<n§½TI4¦ edIm,IbBa¢ak;fa RsþImanépÞeBaHenaH)aneFVIetsþRsavRCavrk emeraKsVay nigbBa¢ak;BIlT§pletsþ pgEdr. RbsinebIRsþIenaH)aneFVIetsþ RtUvKUssBaØa enAkñúg

xÞg; “eFVIetsþrkemeraKsVay”. cMeBaHlT§pletsþ viC¢man bJu GviC¢man RtUvsresrenAkñúgxÞg; “lT§pl

etsþ” edayKUssBaØa (+) bJu (-). • RtUvrkSabBa¢IsMrg;Bt’manenaHenAesvaBinitüépÞeBaHmuneBlsMral edIm,IbgáarmineGay)at;bg; niggay

RsYlrkBt’manTaMgenaHeLIgvijpg.

‐ 20 ‐ 

 

7>2 snøwksMrg;Bt’manrbs;RsþIBinitüépÞeBaHmuneBlsMral ¬ ]bsm<n§½TI5¦ • RtUveRbIR)as;snøwksMrg;Bt’manrbs;RsþIBinitüépÞeBaHmuneBlsMral EdlkMBugeRbIR)as;enAtammNÐlsux

PaB nigmnÞIreBTübEg¥k edIm,Ikt;RtaTukral;Bt’manEdlTak;TgnwgRsþImanépÞeBaHenaH. • RtUvbBa©ÚlsnøwkbEnßm (additional sheet) sþIBIkarRsavRCavrkCMgWsVay P¢ab;CamYynwgsnøwksMrg;

Bt’manrbs;RsþIBinitüépÞeBaH edIm,Ikt;RtaTuknUvBt’mansþIGMBIkareFVIetsþrkemeraKsVay nigkarBüa)al CUnRsþIenaH.

• RtUvrkSasnøwksMrg;Bt’manenaHenAesvaBinitüépÞeBaHmuneBlsMral edIm,IbgáarmineGay)at;bg; niggay RsYlrkBt’manTaMgenaHeLIgvijpg.

7>3 esovePAsuxPaBmata ¬ ]bsm<n§½TI6¦ • RtUveRbIR)as; “esovePAsuxPaBmata” EdlmNÐlsuxPaB nigmnÞIreBTübEg¥k)anRbKl;CUndl;RsþI

EdlmkBinitüépÞeBaH edIm,IeGayGñkpþl;esvaEfTaMsuxPaBkt;RtaTukral;Bt’manrbs;RsþIenaHenAerog ral;eBlmanépÞeBaHmþg².

• RtUvbBa©ÚlsnøwkbEnßm (additional sheet) sþIBIkarRsavRCavrkCMgWsVay eTAkñúgesovePAsuxPaBmata edIm,Ikt;RtaTuknUvBt’mansþIGMBIkareFVIetsþrkemeraKsVay nigkarBüa)alCUnRsþIenaH.

• “esovePAsuxPaBmata” RtUvrkSaTukedayRsþIxøÜnÉgpÞal; ehIyRtUvykmkCab;nwgxøÜnKat; enAral;eBl EdlKat;mkBinitüépÞeBaHmuneBlsMralenAmNÐlsuxPaB bJumnÞIreBTübEg¥k ehIyRtUveRbIR)as;esovePA enHral;eBlEdlKat;manépÞeBaH ebIeTaHbICaenAeBlKat;QWeBaHsMralkUnk¾eday. viFIenHeFVIeGayGñk pþl;esvaEfTaMsuxPaBGacTTYl)annUvBt’manepSg²EdlTak;TgnwgépÞeBaHrbs;Kat; enAeBlEdlKat; mkBinitüsuxPaBmþg².

‐ 21 ‐ 

 

7>4 r)aykarN_ ¬ ]bsm<n§½TI7¦ • mNÐlsuxPaB/ mnÞIreBTübEg¥k/ KøIniksuxPaBRKYsar nigKøInikGgÁkarminEmnrdæaPi)al RtUvepJI

r)aykarN_sþIGMBIkareFVIetsþRsavRCavrkCMgWsVay erogral;RtImasmkEpñkRKb;RKgTinñn½yénmCÄmNÐl CatiRbyuT§nwgCMgWeGds_ esIEs,k nigkameraK. bnÞab;BIkarbUksrub r)aykarN_enHnwgRtUv)anpSBVpSay CUndl;sßabn½Bak;Bn§½nana CaBiessmCÄmNÐlCatiKaMBarmatanigTark.

• RtUveRbIR)as;snøwkbEnßm (additional sheet) sþIBIr)aykarN_énkareFVIetsþRsavRCavrkCMgWsVay ¬sUm emIl]bsm<n§½TI7¦ P¢ab;mkCamYynwgr)aykarN_RbcaMRtImassþIBIkrNICMgWkameraKsMrab;mNÐlsuxPaB mnIÞreBTübEg¥k/ KøIniksuxPaBRKYsar nigKøInikGgÁkarminEmnrdæaPi)alEdlmanesvaeFVIetsþRsavRCavrk CMgWsVaycMeBaHRsþImanépÞeBaHmuneBlsMral.

‐ 22 ‐ 

 

]bsm<n§½TI1 ³ kareFVIetsþRsavRCavrkemeraKbgáCMgWsVaycMeBaHRsþImanépÞeBaH

tamdanlT§pletsþkñúgry³ eBlBI 6 eTA 12 ExeRkay. ]> enAExTI 9bnÞab;BIsMralkUn *

RsþImkBinitüépÞeBaHCaelIkdMbUg (ANC)

- Gb;rM nigpþl;RbwkSa - CMrujeGayeRbIR)as;eRsamGnam½y

nigpþl;eRsamCUnKat; - CMrujeGayeFVIetsþrkemeraKeGds_

etImandMe)AbJuBgTwk¼Ebk enARbdab;bnþBUCEdrbJueT?

RPR titre (quantitative) edIm,IrkSa lT§pletsþenaH CaeKal (baseline)

eRbIKMnUsbMRBYjsþIBIkarEfTaMBüa)aldMe)AelIRbdab;bnþBUC

Büa)alCMgWsVay - Benzathine-Penicillin G 2.4 lan units cak;sac;dMuEtmþgKt; - Gb;rM nigpþl;RbwkSa - CMrujeGayeRbIR)as;eRsamGnam½y nigpþl;eRsamCUnKat; - RKb;RKg nigEfTaMBüa)alédKUrYmePT - CMrujeGayeFVIetsþrkemeraKeGds_

viC¢man

Rapid test

GviC¢man

RPR test GviC¢man

viC¢man

lT§pletsþ RPR titre Føak;cuHes μ I bJuelIsBI 2 titres (≥ 2 titres)**

lT§pletsþ RPR titre ekIneLIg bJuminERbRbYl bJuFøak;cuHticCag 2 titres (≤ 2 titres)

- Gb;rM nigpþl;RbwkSa - CMrujeGayeRbIR)as;eRsamGnam½y nigpþl;eRsamCUnKat; - CMrujeGayeFVIetsþrkemeraKeGds_ ¬RbsinebIminTan;eFVI¦ - RtUvBüa)alCMgWsVayCUnédKUrYmePTrbs;Kat; RbsinebI

édKUenaHminTan;)anTTYlkarBüa)alenAeLIy.

karBüa)alGacbraC½y bJuRsþIGacqøgCMgWsVayCaf μI bJuk¾CaCMgW sVayEdl)anqøgyUrNas;mkehIy. RtUv Büa)alCMgWsVay sarCaf μ IeLIgvij ry³eBlbIs)þah_ ³ - Benzathine-Penicillin G 2.4 lan units

cak;sac;dMumYydgkñúg 1s)þah_ ry³eBlbIs)þah_ - RtUvelIkTwkcitþeGayRsþIeFVIetsþrkemeraKeGds_ - RtUvBüa)alCMgWsVayCUnédKUrYmePTrbs;Kat; - CMrujeGayeRbIR)as;eRsamGnam½y nigpþl;eRsamCUnKat;

* mþaynaMkUnmkmNÐlsuxPaBbJumnÞIreBTübEg¥k edIm,Icak; v:ak;saMgkarBarCMgWkRBa¢il.

** ]> Føak;cuHBI 1:16 mkenARtwm 1:4

Kμan

man

‐ 23 ‐ 

 

]bsm<n§½TI2 ³ karEfTaMBüa)alTarkEdlekItecjBImþaymanqøgCMgWsVay

TarkekItecjBImþaymanCMgWsVay

etImaneraKsBaØaEdlsgS½yfaCaCMgWsVayBIkMeNItEdrbJueT?

bBa¢Ún

eT

Binitütamdan

Büa)alCMgWsVayBenzathine-Penicillin

cak;sac;dMuEtmþgKt;

man esvacak;v:ak;saMgbgáareraK

eraKsBaØaKøInikEdlnaMeGaysgS½yfaGacCaCMgWsVayBIkMeNIt ¬enAeBlTarkekItPøam bJuenAeBlBinitütamdan¦ ³ - TarkekItminRKb;Ex bJuTarkekItmkmanTMgn;ticCagFmμta - manhUrsMe)ar bJuTwkrégBIRcmuHruaMér: - sm,úrelOg ¬PñasesImenAEPñkelOg¦ - eføIm/ GeNþIk bJukUnkNþúrrIkFM - knÞÜlrmas;Es,k CYnkalEs,ks¶Üt bJumanBgTwktUc² bJuEbkRska bJuesIm² CaBiessenAéd/ eCIg

bJuenAbrievNCMuvijmat; bJurn§KUf - RTg;RTayq¥wgenARcmuH bJueCIgmanlkçN³minFm μta-evoc.

eFVIetsþ DNA PCR

rkemeraKeGds_

ral;eBlkumarmk TTYlkarcak;v:ak; saMgbgáareraK ¬s)aþh_TI 6-10-14 nigExTI 9¦ RtUvBinitürkemIl eraKsBaØaKøInikénCMgWsVayBIkMeNIt

bBa¢ÚneTAesvaÉkeTsCMgW kumar bJueTAmnÞIreBTübEg¥k

man

‐ 24 ‐ 

 

]bsm<n§½TI3 ³ etsþ Standard SD Bioline Syphilis 3.0

sMPar³EdlRtUvkarsMrab;eFVIetsþenHKW Micropipette nig Tips EdlmancMNuH 10ul . karGnuvtþn_ ³

• dkykbnÞHetsþecjBIkBa©b; ehIydak;elIkEnøgEdlmanépÞrabesμ I • bnþk;esr:UmQam bJuQamsuT§ cMnYn 10ul edayyWt²eTAelIkEnøgsMrab;dak;vtßúviPaKrbs;bnÞHetsþ • bnþk;l,ayetsþ bI dMNk; eTAelIkEnøgsMrab;dak;vtßúviPaKrbs;bnÞHetsþ • BinitüemIllT§pletsþry³eBl 5 eTA 20 naTIeRkay

lT§pl GviC¢man RbsinebImanelcecjbnÞHqñÚtEtmYy enaHbBa¢ak;fa lT§pletsþ “GviC¢man” lT§pl viC¢man RbsinebImanelcecjbnÞHqñÚtcMnYn BIr ¬C nig T¦ enaHbBa¢ak;fa lT§pletsþ “viC¢man” lT§pl minGackMNt;)an RbsinebIKμanelcecjbnÞHqñÚtNamYyeT bnÞab;BIeFVIetsþ enaHbBa¢ak;fa lT§pletsþ “minGackMNt;)an”

‐ 25 ‐ 

 

]bsm<n§½TI4 ³ xÞg;bEnßmsMrab;bBa¢IsMrg;Bt’manBinitüépÞeBaHmuneBlsMral (Additional columns to Antenatal Register) kMNt;cMNaM ³ - cMeBaHesvasuxaPi)alenAtamRsukRbtibtþiEdlkMBugGnuvtþyuT§saRsþénkareqøIytbrYmKña cMeBaHkarbgáar nig

EfTaMBüa)alCMgWeGds_-kameraK nigsuxPaBbnþBUC (Linked Response for Prevention, Care, and

Treatment of HIV/AIDS and Sexual and Reproductive Health Issues) RtUveRbIR)as; esovePA cuHbBa¢IRsþImanépÞeBaHEdlsμR½KcitþTTYlkarpþl;RbwkSanigeFVIetsþQamrkemeraKeGds_ enAEpñkBinitüépÞeBaH Edl)anpþl;CUnedaymCÄmNÐlCatiRbyuT§nwgCMgWeGds_ esIEs,k nigkameraK.

- RtUvBinitürkeraKsBaØadMe)AelIRbdab;bnþBUC nigeFVIetsþRsavRCavrkemeraKsVay eday “ Rapid test ”

(Treponemal test) cMeBaHRsþImanépÞeBaHTaMgGs;Edl)anmkBinitüsuxPaBenAesvaBinitüépÞeBaHmuneBl sMral. RbsinebIlT§ pl Rapid test viC¢man RtUveFVIetsþbBa¢ak;eday “ RPR test ” (Non-treponemal

test) . kareFVIetsþRsavRCavrkemeraKsVay Rapid test RPR test

(+) (-) (+) (-)

‐ 26 ‐ 

 

]bsm<n§½TI5 ³ snøwkbEnßmsMrab;sMrg;Bt’manBinitüépÞeBaHmuneBlsMral (Additional sheet to Antenatal Record) kMNt;cMNaM ³ RtUvBinitürkeraKsBaØadMe)AelIRbdab;bnþBUC nigeFVIetsþRsavRCavrkemeraKsVay eday “ Rapid test ”

(Treponemal test) cMeBaHRsþImanépÞeBaHTaMgGs;Edl)anmkBinitüsuxPaBenAesvaBinitüépÞeBaHmuneBlsMral.

4 kareFVIetsþRsavrkemeraKsVay kalbriecäT>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• BgTwk¼dMe)AelIRbdab;bnþBUC man K μan min)anBinitü kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• Rapid test rkemeraKsVay (+) (-) min)aneFVI kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• RPR test rkemeraKsVay (+) (-) min)aneFVI kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• Rbtikm μCamYy»sf Penicillin man K μan mindwgc,as; kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• Büa)alCMgWsVay man Kμan kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• RPR titre Baseline………………… min)aneFVI kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Follow-up……………… ………………

• GeBa¢IjédKUrYmePTeGaymkBüa)al man K μan kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• édKUrYmePT)anTTYlkarBüa)al man K μan kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• Tark)anTTYlkarBüa)al man K μan kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• bBa¢ÚneTAesva PMTCTRbsinebI man K μan kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> minTan;)aneFVIetsþrkemeraKeGds_

kalbriecäTNat;CYbelIkeRkayeTot ¬RbsinebIcaM)ac;¦>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> kMNt;cMNaM ³

RbsinebIdwgc,as;fa lT§pl Rapid test viC¢man cab;BIeBlmanépÞeBaHelIkmunmk eKmincaM)ac;eFVIetsþenHsarCafμ I eLIgvijeT. cUreFVIetsþ “ RPR test ” (qualitative nig quantitative) kñgeBldMNalKñaEtmþg.

‐ 27 ‐ 

 

]bsm<n§½TI6 ³ snøwkbEnßmsMrab;esovePABinitüsuxPaBmata (Additional sheet to Mother Health Record’s Book) kMNt;cMNaM ³ TMrg;sMrg;Bt’manenHKWCasnøwkbEnßmeTAkñúgesovePAsuxPaBmata.

kareFVIetsþRsavRCavrkemeraKsVay kalbriecäT>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• BgTwk¼dMe)AelIRbdab;bnþBUC man K μan min)anBinitü kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• Rapid test rkemeraKsVay (+) (-) min)aneFVI kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• RPR test rkemeraKsVay (+) (-) min)aneFVI kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• Rbtikm μCamYy»sf Penicillin man K μan mindwgc,as; kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• Büa)alCMgWsVay man Kμan kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• RPR titre Baseline………………… min)aneFVI kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> Follow-up……………… ………………

• GeBa¢IjédKUrYmePTeGaymkBüa)al man K μan kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• édKUrYmePT)anTTYlkarBüa)al man K μan kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• Tark)anTTYlkarBüa)al man K μan kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

• bBa¢ÚneTAesva PMTCTRbsinebI man K μan kMNt;cMNaM>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> minTan;)aneFVIetsþrkemeraKeGds_

kalbriecäTNat;CYbelIkeRkayeTot ¬RbsinebIcaM)ac;¦>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> kMNt;cMNaM ³

RbsinebIdwgc,as;fa lT§pl Rapid test viC¢man cab;BIeBlmanépÞeBaHelIkmunmk eKmincaM)ac;eFVIetsþenHsarCafμ I eLIgvijeT. cUreFVIetsþ “ RPR test ” (qualitative nig quantitative) kñgeBldMNalKñaEtmþg.

‐ 28 ‐ 

 

]bsm<n§½TI7 ³ r)aykarN_RbcaMRtImassþIBIkrNICMgWkameraK kMNt;cMNaM ³ TMrg;sMrg;Bt’manenHKWCasnøwkbEnßmsþIGMBIkareFVIetsþRsavRCavrkemeraKsVaycMeBaHRsþImanépÞeBaH EdlP¢ab;CamYynwgr)aykarN_RbcaMRtImassþIBIkrNICMgWkameraKEdlbBa¢ÚnmkBIKøIniksuxPaBRKYsar bJumNÐlsuxPaB EdlmanesvaenH.

kareFVIetsþRsavRCavrkemeraKsVaycMeBaHRsþImanépÞeBaH Ex>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> RtImasTI>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> qñaM 20>>>>>>>>>>> eQμaHKøIniksuxPaBRKYsar bJumnÞIreBTübEg¥k bJumNÐlsuxPaB>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> RsukRbtibtþi>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> extþ>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> karEbgEcktamGayu

srub kareFVIetsþrkemeraKsVay ticCag 15 qñaM 15-49 qñaM elIsBI 50qñaM

cMnYnRsþITaMgGs;EdlmkBinitüépÞeBaHelIkTI1 enAesvaBinitüépÞeBaHmuneBlsMral

cMnYnRsþITaMgGs;Edl)aneFVI Rapid test

cMnYn Rapid test (+)

cMnYnRsþITaMgGs;Edl)aneFVI RPR qualitative test

cMnYn RPR test (+)

cMnYnRsþImkBinitüépÞeBaH Edl)anBüa)alCMgWsVay

cMnYnRsþImanCMgWsVayEdl)aneFVI RPR quantitative test (titre)

cMnYnRsþIeFVIetsþ RPR- Titre - baseline

cMnYnRsþIeFVIetsþ RPR- Titre - follow up

cMnYnsrub édKUEdl)anTTYlkarBüa)alCMgWsVay

cMnYnsrub TarkEdl)anTTYlkarBüa)alCMgWsVay

‐ 29 ‐ 

 

]bsm<n§½TI8 ³ karRKb;RKgEfTaMGñkCMgWEdlmanRbtikm μCamYy»sf (Management of anaphylaxis) RbtikmμCamYynwg»sf (Anaphylaxis) GacekItmaneLIgCayfaehtu enAKøInikeBlEdlGñkCMgWTTYlkarBüa)al. RKUeBTüRtUveFVIkarseRgÁaHGñkCMgWCabnÞan;Pøam² enAeBlEdlKat;manRbtikmμCamYynwg»sfBüa)al. dUecñH RtUvEtman»sf Adrenaline sMrab;eRbIR)as;Pøam² RbsinebIkrNIenHekItmaneLIg enAeBlNaEdlRKUeBTü cak;v:ak;saMg bJueRbI»sfcak;CUnGñkCMgW.

1- eraKsBaØaénkarmanRbtikmμCamYynwg»sf GñkCMgWGacdwgfaxøÜnmanRbtikmμCamYynwg»sf enAeBlEdlKat;maneraKsBaØadUcteTA ³

- cab;epþImtwg-fb;degðImPøam² (wheeze) - Bi)akdkdegðIm - ehIm-ehImmux/ bbUrmat; nigGNþat - eLIgsVay-sVaybbUrmat; nigRmaméd - CIBcredIrjab; - sMBaFQamcuHTab - eLIgknÞÜl-rmas; EdlekIteLIgy:agqab;rh½sCamYyeraKsBaØaxagelI.

2- karRKb;RKgEfTaMCabnÞan;cMeBaHGñkCMgWEdlmanRbtikmμCamYy»sf

- dak;GñkCMgWeGayedksNþÚkep¥ógmkxageqVg - erobcMsMrYleGaymanxül;dkdegðIm RbsinebIGñkCMgWQb;dkdegðIm bJuCIBcrenAsésrbMBg;k

(Carotide pulse) minGacsÞabeXIj RtUvcab;epþImCYyseRgÁaHdl;ebHdUg-sYt CabnÞan;Pøam edIm,IeGaysrIragÁenHdMeNIrkareLIgvij

- esñIsMuCMnYyseRgÁaHbnÞan;Pøam².

3- kareRbIR)as;»sf Adrenaline - RtUvcak;»sf cUlkñuúgsac;dMueGayeRCA edayeRbIsWruaMgcMNuH 1 m>l> nigm¢úlelx 23 G .

‐ 30 ‐ 

 

Dose of Adrenaline = 0.01ml/kg*

AGE/WEIGHT DOSE OF ADRENALINE (ml of 1:1000) 1-2 years (approx 3 - 10 kg) 0.03 - 0.1 ml 2-3 years (approx 10 kg) 0.1 ml 4-6 years (approx 15 kg) 0.15 ml 7-10 years (approx 20 kg) 0.2 ml 11-12 years (approx 25 - 30 kg) 0.25 - 0.3 ml 12 - 14 years (approximately 40 kg) 0.4 ml Adult 0.5 ml

- RKUeBTüRtUvføwgkumar bJuBinitüemIlTMgn;kumarkalBIelIkmun enAkñuúgesovePAkt;RtaBt’manrbs;GñkCMgW

k¾bu:EnþminRtUveFVIeGaymankaryWty:avdl;karseRgÁÁaHTarkeT. - RtUveRbI»sf Adrenaline CabnþbnÞab;ry³eBl 5 naTImþg cMeBaHmnusSeBjv½y bJu 10 eTA 15

naTImþg cMeBaHkumarrhUtTal;EtmansPaBFUrRsaleLIgvij.

4- karEfTaMbEnßmeRkayBIkarcab;epþImcak;»sf Adrenaline - cab;epþImcak;bBa©Úlesr:UméRbPøam² - dak;xül;GuksIuEsn 100° edayBak;m:as;elImuxGñkCMgW (face-mask) kñúgcMNuH 8 lIRtkñúg 1 naTI

ehIyrkSaeGayxül;GacecjcUltampøÚvdkdegðIm)anl¥ - bBa¢ÚnGñkCMgWtamrfynþseRgÁaHbnÞan; RbsinebIGaceFVIeTA)an. dak;GñkCMgWeGaysMrakBüa)alenAkñúg

mnÞIreBTü edIm,IBinitütamdanbnþ nigpþl;karEfTaMBüa)al - BinitütamdankarBüa)al nigsBaØaepSg² dUcCa sm<aFQam/ cgVak;ebHdUg/ sItNðPaB/

cgVak;degðIm/ kMhab;GuksIuEsn .l. erogral;ry³eBl 10-15 naTImþg nigkt;RtalT§plTuk.

‐ 31 ‐ 

 

]bsm<n§½TI9 ³ KMnUsbMRBYjsþIBIdMe)AenAelIRbdab;bnþBUC (Genital Ulcer Management)

karEfTaMBüa)aledayBwgEp¥kelIcegáameraKsBaØa ¬ KμanmnÞIrBiesaFn_¦

GñkCMgWt¥ÚjEt¥rfamanBgTwkbJudMe)AenAelIRbdab;bnþBUC

etImandMe)A BitR)akEdrb¤eT?

man

etImanBgTwk¼Ebk Edr b¤eT?

eT eT

man

Rsg;RbvtþinigBinitüGñkCMgW

- Gb;rMGñkCMgWeGaypøas;bþÚrkarRbRBwtþ - CMrujkareRbIR)as; nig

pþl;eRsamGnam½y - pþl;RbwkSaeFVIetsþQam

rkemeraKeGds_

- Büa)alCMgWBgTwk¼Ebk - Gb;rMedIm,IeGayGñkCMgWpøas;bþÚrkarRbRBwtþ - CMrujkareRbIR)as; nigpþl;eRsamGnam½y - RKb;RKgEfTaMBüa)alédKUrYmePT - pþl;RbwkSaeFVIetsþQam rkemeraKeGds_

- Büa)alCMgWsVay nigCMgW Chancroid - Gb;rMedIm,IeGayGñkCMgWpøas;bþÚrkarRbRBwtþ - CMrujkareRbIR)as; nigpþl;eRsamGnam½y - RKb;RKgEfTaMBüa)lédKUrYmePT - pþl;RbwkSaeFVIetsþQam rkemeraKeGds_ - Büa)alCMgWehImRKelon edayEp¥kelIlkçN³eGBIedmIsaRsþ RbsinebI

GñkCMgWminFUrRsalkñúgeBlmktamdan b¤karmkBinitüelIkdMbUg - R)ab;GñkCMgWeGayvilRtLb;mkCYbvij ebIcaM)ac; .

‐ 32 ‐ 

 

karEfTaMBüa)aledayBwgEp¥kelIetsþmnÞIrBiesaFn _  

GñkCMgWt¥ÚjEt¥rfamanBgTwkbJudMe)AenAelIRbdab;bnþBUC

etImandMe)A BitR)akEdrb¤eT?

eT eT

man

Rsg;RbvtþinigBinitüGñkCMgW - Gb;rMGñkCMgWeGaypøas; bþÚrkarRbRBwtþ

- CMrujkareRbIR)as; nig pþl;eRsamGnam½y

- pþl;RbwkSaeFVIetsþQam rkemeraKeGds_

Büa)alCMgWBgTwk¼Ebk - Gb;rMedIm,IeGayGñkCMgW

pøas;bþÚrkarRbRBwtþ - CMrujkareRbIR)as;

nigpþl;eRsamGnam½y - RKb;RKgEfTaMBüa)al

édKUrYmePT - pþl;RbwkSaeFVIetsþQam

rkemeraKeGds_

(-)

TPPA test 

Büa)alCMgWsVay nigCMgWBgTwk¼Ebk - Gb;rMedIm,IeGayGñkCMgWpøas;bþÚrkarRbRBwtþ - CMrujkareRbIR)as; nigpþl;eRsamGnam½y - RKb;RKgEfTaMBüa)alédKUrYmePT - pþl;RbwkSaeFVIetsþQam rkemeraKeGds_

RPR test 

(+)

etImanBgTwk¼Ebk Edr b¤eT?

Büa)alCMgWsVay nigCMgW Chancroid - Gb;rMedIm,IeGayGñkCMgWpøas;bþÚrkarRbRBwtþ - CMrujkareRbIR)as; nigpþl;eRsamGnam½y - RKb;RKgEfTaMBüa)alédKUrYmePT - pþl;RbwkSaeFVIetsþQam rkemeraKeGds_ - Büa)alCMgWehImRKelon edayEp¥kelIlkçN³

eGBIedmIsaRsþ RbsinebIGñkCMgWminFUrRsal kñúgeBlmktamdan b¤karmkBinitüelIkdMbUg

- R)ab;GñkCMgWeGayvilRtLb;mkCYbvij ebIcaM)ac; .

man

(-)

(+)

‐ 33 ‐ 

 

]bsm<n§½TI10 ³ TIkEnøgEdl)andMeNIrkaresvaeFVIetsþQamrkemeraKsVaycMeBaHRsþImanépÞeBaH enAkñúgqñaM 2008 enH manesvaEfTaMsuxPaBcMnYn 34 Edl)aneGaycab;epþImdMeNIrkaresvaeFVIetsþQamrkemeraK sVaycMeBaHRsþImanépÞeBaH edaykareFVI “RAPID TEST” ³ esvaEfTaMsuxPaBEdlkMBugdMeNIrkareFVIetsþQamrkemeraKsVay ¬bnþskm μPaBenAkñúgqñaM 2008¦³

1- mCÄmNÐlCatiKaMBarmata nigTark 2- mNÐlsuxPaB ³

extþ-Rkug RsukRbtibtþi mNÐlsuxPaB ]btßmÖKaMRTeday ³

esomrab esomrab 2 bnÞayRsI GgÁkar RACHA 3 kRnÞaMg GgÁkar RACHA 4 mNÐl 1 GgÁkar RACHA

5 esomrab GgÁkar RACHA GgÁrCMu 6 BYk GgÁkar RACHA

7 ssrsþm GgÁkar RACHA RkLaj; 8 kMBg;fáÚv GgÁkar RACHA

eBaFisat; sMeBAmas 9 keNþóg GgÁkar RACHA

10 RkKr GgÁkar RACHA 11 BalEjk GgÁkar RACHA 12 PñMRkvaj GgÁkar RACHA

)akan 13 bwgxñar GgÁkar RACHA kMBt GgÁrC½y 14 tanI GgÁkar RACHA

kMBt 15 RkaMgGMBil GgÁkar RACHA QUk 16 QUk GgÁkar RACHA kMBg;Rtac 17 kMBg;Rtac GgÁkar RACHA

‐ 34 ‐ 

 

3- KøInikGgÁkarminEmnrdæaPi)al ³

extþ-Rkug RsukRbtibtþi KøIniksuxPaB ]btßmÖKaMRTeday ³PñMeBj 18 sÞwgmanC½y GgÁkar RHAC

19 cak;GERg GgÁkar RHAC 20 TYlsEgá GgÁkar RHAC

21 Twkføa GgÁkar RHAC 22 TMnb;fμ I GgÁkar RHAC

23 pSaredb:U GgÁkar RHAC 24 TYlTMBUg GgÁkar RHAC

RkugRBHsIhnu RkugRBHsIhnu 25 RkugRBHsIhnu GgÁkar RHAC

)at;dMbg )at;dMbg 26 )at;dMbg GgÁkar RHAC kMBg;cam kMBg;cam 27 kMBg;cam GgÁkar RHAC

eCIgéRB 28 p¥av GgÁkar RHAC

t,ÚgX μ Mú 29 sYg GgÁkar RHAC taEkv dUnEkv 30 taEkv GgÁkar RHAC

esomrab esomrab 31 esomrab GgÁkar RHAC RkLaj; 32 BYk GgÁkar RHAC

kMBg;s<W kMBg;s<W 33 kMBg;s<W GgÁkar RHAC

sVayerog CIPU 34 )avit GgÁkar RHAC

‐ 35 ‐ 

 

esvaEfTaMsuxPaBEdlnwgerobcMeGaydMeNIrkareFVIetsþQamrkemeraKsVay ¬enAkñúgqñaM 2009¦³ 1- mNÐlsuxPaB ³

extþ-Rkug RsukRbtibtþi mNÐlsuxPaB ]btßmÖKaMRTeday ³

bnÞaymanC½y e):ayEb:t 35 e):ayEb:t US-CDC mgÁlbUrI 36 esrIesaP½N US-CDC

)at;dMbg )at;dMbg 37 sVaye):a US-CDC sMeBAlUn 38 mnÞIreBTübEg¥ksMeBAlUn US-CDC

éRBEvg éRBEvg 39 HC Sub-satellites CHAI (?) GñkelOg 40 HC Sub-satellites CHAI (?) RBHesþc 41 HC Sub-satellites CHAI (?) kMBg;RtEbk 42 HC Sub-satellites CHAI (?) emsag 43 HC Sub-satellites CHAI (?)

taEkv KIrIvgS 44 HC Sub-satellites EU/ITM

2- KøInikGgÁkarminEmnrdæaPi)al ³

extþ-Rkug RsukRbtibtþi KøIniksuxPaB ]btßmÖKaMRTeday ³ PñMeBj 45 c,arGMeBA Marie Stopes

kNþal taexμA 46 taexμA Marie Stopes

ekaHkug s μac;manC½y 47 ekaHkug Marie Stopes