STD care in Zambia: an evaluation of the guidelines for case management through a syndromic approach

• Published in: International journal of STD & AIDS Vol. 7; no. 5; p. 324
• Main Authors: Hanson, S, Sunkutu, R M, Kamanga, J, Höjer, B, Sandström, E
• Format: Journal Article
• Language: English
• Published: England 01-08-1996
• Subjects: Evaluation Studies as Topic; Female; Humans; Male; Practice Guidelines as Topic; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - therapy; Zambia; Zambia; Programs; Eastern Africa; Organization And Administration; Africa; Infections; Zambia; Research Methodology; English Speaking Africa; Examinations And Diagnoses; Diseases; Studies; Sexually Transmitted Diseases; Treatment; Reproductive Tract Infections; Signs And Symptoms; Research Report; Developing Countries; Africa South Of The Sahara; Program Evaluation; Longitudinal Studies
• ISSN: 0956-4624
• DOI: 10.1258/0956462961918211

Clinical diagnosis of STDs is unreliable and therefore constitutes a poor basis for choice of treatment. A syndromic approach has been suggested to increase effectiveness of treatment in resource poor settings. Algorithms for the treatment of STD syndromes were evaluated. A total of 436 patients were followed; cure rates were defined and estimated for genital ulcer disease (GUD), urethral and vaginal discharge. Cure rates for the discharge syndromes were high, 97-98%, for both sexes. The cure rate for GUD was 83% for female and 69% for male patients. A higher prevalence of syphilis in the female study population probably contributed to this. It is likely that a large proportion of the treatment failures were due to decreased susceptibility of Haemophilus ducreyi to trimethoprim-sulpha. The determination of cure rates met with a number of methodological problems. This makes it difficult to evaluate the algorithms as part of routine activities, as suggested earlier by WHO.