Evaluation of syndromic management guidelines for treatment of sexually transmitted infections in South African women.
Trop Med Int Health
; 21(9): 1138-46, 2016 09.
Article
em En
| MEDLINE
| ID: mdl-27350659
ABSTRACT
OBJECTIVE:
To evaluate the performance of three different guidelines for the management of vaginal discharge syndrome (VDS) for women living in a rural setting in South Africa.METHODS:
We conducted a secondary analysis of data from a cross-sectional study in Mopani District, South Africa. The 2015 and 2008 guidelines of the South African Department of Health (DoH) and the most recent WHO guidelines were evaluated for adequate treatment of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis infection.RESULTS:
Of the 489 women included in this analysis, 35% presented with VDS according to the DoH and 30% per WHO definition of VDS. Fifty-six per cent of the women with VDS would be treated adequately for these STI when using the 2015 DoH guideline, whereas 76% (P = 0.01) and 64% (P = 0.35) would receive adequate treatment with the 2008 DoH and WHO guidelines, respectively. Of the symptomatic women who tested negative for all four STI, STI treatment would have been indicated for 36% as per 2015 DoH guideline vs. 69% (P < 0.001) per 2008 DoH and 67% (P < 0.001) per WHO guidelines.CONCLUSION:
A considerable proportion of symptomatic women infected with these common curable STI would receive adequate treatment when using a syndromic management approach, and significant differences exist between the three guidelines. Many symptomatic women without these STI receive broad-spectrum antibiotics, so new approaches are needed to improve syndromic STI control.Palavras-chave
Afrique du Sud; South Africa; Sudáfrica; emplazamiento con pocos recursos; infección de transmisión sexual; infections sexuellement transmissibles; low-resource setting; manejo sindrómico; milieu à faibles ressources; prise en charge syndromique; sexually transmitted infection; syndrome d'écoulement vaginal; syndromic management; síndrome de descarga vaginal; vaginal discharge syndrome
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Trichomonas
/
Infecções Sexualmente Transmissíveis
/
Chlamydia trachomatis
/
Guias de Prática Clínica como Assunto
/
Descarga Vaginal
/
Mycoplasma genitalium
/
Neisseria gonorrhoeae
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Middle aged
País/Região como assunto:
Africa
Idioma:
En
Revista:
Trop Med Int Health
Assunto da revista:
MEDICINA TROPICAL
/
SAUDE PUBLICA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
África do Sul