EFFECT OF IUD (INTRAUTERINE DEVICE) ON REPRODUCTIVE TRACT INFECTION (RTI) IN THE NORTHERN WEST BANK

In a study about qualitative research for RTI conducted in Egypt by the Population Council, it was determined that 51% of the women had RTIs ¹⁹.  Table 4 in our study shows that 87% of women had at least one or more symptoms related to RTI. Although these symptoms were much more common among IUD users, these results are pointing to an important and common problem in our society.

Different approaches are followed all over the world to diagnose, treat and manage the symptoms related to RTI at the level of Primary Health Clinic either in the Family Planning or Maternal &Child Health clinics, examples are culture swab, gram stain, Amsel criteria, or syndromic approach that have been developed by WHO. Syndromic approach  have proven to be so effective in poor countries with high prevalence rate of STD, and where limited services are available for use in the diagnosis ¹³.

Conclusion
Vaginitis and RTI are common problems among women in Palestine. There is a special important association between IUD use and these types of infection. Although symptoms are important in clinical 

evaluation of these infections, the type of aerobic microorganism cannot be predicted by these symptoms. Health workers in the family planning and primary health care clinics should be aware of vaginitis, and the different types of RTI, their proper diagnosis, prevention and treatment, and the association of these infections with contraceptive methods. Teaching and training of these health workers about taking the available opportunities during FP and PHC clinic visits is an important step .A study in Bangladesh found that RTIs are important health problems that affect women of reproductive age but often remain unexplored in the current service delivery system. Furthermore clinicians failed to elicit necessary reproductive health information from clients, across all types of clinics ²⁰. A protocol for diagnosis and treatment needs to be developed by MOH and other health organizations in Palestine.