Surveillance, prevention, and control of sexually transmitted agents associated with pelvic inflammatory disease.

Control and prevention of pelvic inflammatory disease would result from successful control of Neisseria gonorrhoeae and genital Chlamydia trachomatis infections. The same control system applies to both, but while this system is well documented in gonorrhea control, there is still no evidence that it is effective for C. trachomatis infections. Primary prevention of PID should be realized through a reduction of the incidence of gonorrhea, and the available techniques--(1) contact tracing and epidemiologic treatment, (2) screening and case finding, (3) preventive measures, (4) health education, and (5) training of the health workers--are discussed. Secondary prevention of PID can be achieved through good management of uncomplicated infections due to N. gonorrhoeae and C. trachomatis. The approach must be adapted to local conditions and should be different in developing countries with a specialized health care system for sexually transmitted disease. Good management of PID is crucial in preventing sequelae and most important are tracing and treating the male contacts of patients with PID. Measures of tertiary prevention attempt to rehabilitate the patient; the main sequelae after PID are ectopic pregnancy and infertility. Surgical techniques can restore tubal function, but these methods are complicated and have a low success rate.