Management of vaginal discharge syndrome: how effective is our strategy?

Moodley, Prashini; Sturm, A. Willem

doi:10.1016/j.ijantimicag.2004.02.003

Cited by 9 publications

(8 citation statements)

References 17 publications

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“…This definition was chosen because it can be considered to be the upper limit for syndromic STI treatment (barring any indirect treatment via partner notification or cure of asymptomatic co-infections). However, as a large proportion of STI episodes are asymptomatic, particularly in women,27 even if all symptomatic episodes are cured a large proportion of STIs will remain untreated. This study could be extended to include asymptomatic episodes, but this would require currently unavailable aetiology-specific general population data on the frequency of STI episodes and the proportion of episodes that became symptomatic.…”

Section: Discussionmentioning

confidence: 99%

Low effectiveness of syndromic treatment services for curable sexually transmitted infections in rural South Africa

White

Moodley

McGrath

et al. 2008

Sexually Transmitted Infections

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Objectives:Syndromic sexually transmitted infection (STI) treatment remains a cost-saving HIV prevention intervention in many countries in Africa. We estimate the effectiveness of syndromic treatment for curable STIs in rural KwaZulu-Natal, South Africa, and the trend in STI prevalences before and after the introduction of syndromic treatment in 1995.Methods:Data were available from various clinical studies, surveys of public and private health providers, the general population and women attending antenatal, family planning and child immunisation clinics in rural northern KwaZulu-Natal between 1987 and 2004. Overall effectiveness was defined as the estimated proportion of the annual number of symptomatic curable STI episodes cured by syndromic treatment based on separate estimates for six curable STI aetiologies by gender.Results:Median overall effectiveness was 13.1% (95% CI 8.9 to 17.8%) of symptomatic curable STI episodes cured. Effectiveness increased to 25.0% (95% CI 17.3 to 33.8%), 47.6% (95% CI 44.5 to 50.8%) or 14.3% (95% CI 9.9 to 19.4%) if 100% treatment seeking, 100% correct treatment provision or 100% cure were assumed, respectively. Time-trends were difficult to assess formally but there was little evidence of decreasing STI prevalences. Including incurable but treatable herpes simplex virus (HSV)-2 ulcers in the effectiveness calculation would halve the proportion of ulcers cured or correctly treated, but this reduction could be entirely countered by including episodic antiviral treatment in the national guidelines.Conclusion:Overall effectiveness of syndromic treatment for curable STIs in rural KwaZulu-Natal remains low and there is little evidence of reduced curable STI prevalences. As syndromic treatment is likely to be a cost-saving HIV prevention intervention in South Africa, innovative strategies are urgently needed to increase rates of treatment seeking and correct treatment provision.

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Section: Discussionmentioning

confidence: 99%

Low effectiveness of syndromic treatment services for curable sexually transmitted infections in rural South Africa

White

Moodley

McGrath

et al. 2008

Sexually Transmitted Infections

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“…[25] Vajinal enfeksiyonlara tanı konması için semptom yaklaşımının tanı ve tedavide maliyet etkin olduğu ve özellikle de yüksek risk grubunda olan kadınlarda kullanımının uygunluğu vurgulanmaktadır. [26][27][28] DSÖ, sendromik yaklaşımın özellikle gelişmekte olan ülkelerde birinci basamak çalışanlarına, vajinal enfeksiyonların erken tanı ve tedavisinde destek olacağını bildirmektedir. [26] Aile Çalışmamızda elde edilen sonuçlar, farklı araştırma yöntemleri kullanarak vajinal enfeksiyonları saptamaya çalışan araştırmalardan elde edilen sonuçlar ile benzerlik göstermektedir.…”

Section: Discussionunclassified

Vulvovajinal kandidiyazis tanısına sendromik yaklaşım

Bengi¹

2014

Turk J Fam Pract

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“…19 In contrast, severe gynecological infections can have an asymptomatic or oligosymptomatic progress over the years in a considerable proportion of women, causing severe complications such as chronic pelvic infections in the medium and long run. 6 Clinical and laboratory research studies conducted in Brazil have showed confl icting objective results, i.e., higher rates of STDs in poor populations.…”

Section: Discussionmentioning

confidence: 99%

“…19 The project of the survey "Comportamento Sexual e Percepções da População Brasileira Sobre HIV/Aids" was approved by the Ethics Committee of Faculdade de Saúde Pública of Universidade de São Paulo.…”

Section: Methodsunclassified

Sinais e sintomas associados às doenças sexualmente transmissíveis no Brasil, 2005

Bastos¹,

Cunha²,

Hacker³

2008

Rev. Saúde Pública

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OBJECTIVE: Sexually transmitted infections (STIs) are a major determinant of population disease burden worldwide. The objective of the study was to assess self-reported morbidity associated to STIs according to gender. METHODS:The study data were obtained from a 2005 study consisting of a multistage probabilistic sample of 5,040 respondents, aged 16-65 years, living in urban areas in Brazil. These data were compared with those from a previous 1998 study. Bivariate analyses were carried out using Pearson's chi-square test and simple linear regression followed by logistic regression. RESULTS:In both men and women, the variables: previous HIV testing, personal belief in unfaithful love, and number of sexual partners in a lifetime were signifi cantly associated to STIs. In women only, the covariates: low family income, living in the Mid-West, Southeast and South regions, and reporting of physical violence were independently associated to STIs. In men, the variables associated were: age group (35 years or more), living in the South region and in the state of São Paulo, and self-perceived HIV infection risk. CONCLUSIONS:Signs and symptoms associated to STIs have strong gender differences in the general population and education interventions should be specifi cally targeted to either men or women.

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Management of vaginal discharge syndrome: how effective is our strategy?

Cited by 9 publications

References 17 publications

Low effectiveness of syndromic treatment services for curable sexually transmitted infections in rural South Africa

Low effectiveness of syndromic treatment services for curable sexually transmitted infections in rural South Africa

Vulvovajinal kandidiyazis tanısına sendromik yaklaşım

Sinais e sintomas associados às doenças sexualmente transmissíveis no Brasil, 2005

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