Duties of doctor and patient in diagnosing venereal disease



The occurrence of sexually transmitted diseases in the Czech Republic is subject to the obligatory Reporting of Sexual Diseases, which includes active sexually transmitted diseases including re-infection and death. Individual reports are recorded in the Register of Sexual Diseases (RPN) by regional hygiene stations (KHS). Statistics have been kept since 1959 through the Institute of Health Information and Statistics of the Czech Republic (ÚZIS ČR).

Classical sexually transmitted diseases (syphilis, gonorrhea, ulcus molle, lymphogranuloma venereum, granuloma inguinale) and from the others HIV / AIDS, viral hepatitis, pediculosis, scabies and chlamydia infections are subject to mandatory reporting in the Czech Republic. Dispensing and recording of sexually transmitted diseases fall within the competence of Dermatovenerology.

In the case of classical sexually transmitted diseases, both the doctor and the patient must comply with the legal provisions which give them certain obligations. Individual duties can be divided into duties of doctors, dermatovenereal departments and duties of patients.

Doctor's duties
Reporting of sexually transmitted diseases (Suspicion, Threat and Death) on special prescribed forms. Another duty is to inform the patient about the nature of the disease and possible transmission, the doctor needs to have this written down and signed by the patient. Then the doctor conducts a screening investigation (to identify all contacts and sources of the disease). Subsequently, the doctor is obliged to treat the patient, perform regular examinations and adhere to medical privacy. The final obligation is to report the patient’s violations of regulations, in particular the interruption of treatment and compulsory controls.

Duties of the Dermatovenereal Department
Record keeping and statistics on STDs. The documentation of venereal patients must be kept outside of central records and accessible only to medical staff. All medical personnel working in the dermatovenereal department are obligated to keep medical privacy. One of the main tasks is to perform the screening. The screening investigation shall include active searches for sources of infection and for persons at risk, as listed in the form supplied by the doctor. The screening is conducted by a qualified nurse under the supervision of a physician.

Patient's Duties
A venereal patient is required to undergo an examination, treatment and check-ups. The client is kept in the record throughout the period of illness and is discarded only on the basis of negative results. The patient is obliged to follow all instructions from doctors and medical staff. They must inform the doctor of all contacts and, if known, indicate the source of the infection. They must not endanger other persons by the transmission of the infection (it can be considered as an offence if previously healthy persons are infected by them). They are obliged to report the change of residence to the doctor during the outpatient treatment.

The HIV test is recommended in venereal patients. The examination is carried out only with the consent of the patient. The test may be carried out without the consent of a person accused of committing an offence by endangering with sexual illness or of a person who is being compulsorily treated for sexual illness. In addition, it is possible to perform diagnostic testing in unconscious persons.

Research and Prevention
The patient can visit a dermatovenerologist without a reference from a general practitioner. All data shall be subject to mandatory medical confidentiality. The examination shall be carried out according to the technical equipment of the workplace, if it is not sufficient, the patient shall be sent to the appropriate dermatovenereal department of the hospital or, where appropriate, to the STD centre.

In the context of the prevention and spread of sexually transmitted diseases, preventive measures are provided for safety of neonates, pregnant persons, hospitalised persons, donors of blood, tissues, bone marrow, organs and semen. And also in relation to all persons for whom a history or objective examination cannot exclude an infection or disease as part of a differential diagnosis. The HIV antibody test is recommended, which is voluntary and can only be performed with the consent of the test subject.

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