Syndromic management of sexually transmitted diseases at primary care level, Mozambique.

Abstract:

OBJECTIVE:To assess STD management in primary healthcare facilities where STD clinics and syndromic management guidelines had been introduced. METHODS:In 26 health facilities in selected sites, we observed management of all STD patients presenting in the adult general or STD clinic. We assessed the referral system by analysing patient registers. RESULTS:408 STD patients (65% in STD and 35% in general clinics) were observed. 70% were women. Women were examined less (26% against 75%, p<0.0001), had laboratory tests ordered more (74% against 45%, p=0.0002), were more often diagnosed syndromically (57% against 38%, p=0.008), and received less advice on condom use (19% against 87%, p<0.001) and contact treatment (47% against 81%, p=0.04). Examination, laboratory requests, diagnosis, and treatment were not significantly different in the STD and general clinic. Health education was better in the STD clinic (condom advice 47% against 8%, p <0.001). Only 41% of referred patients presented to the STD clinic. CONCLUSIONS:The better performance of STD clinics in health education was offset by high referral losses. A proposed integration of STD treatment into general outpatient clinics and better implementation of syndromic management and health education should improve STD case management at primary level in Mozambique.

journal_name

Sex Transm Infect

authors

Mbofana FS,Brito FJ,Saifodine A,Cliff JL

doi

10.1136/sti.78.1.e2

subject

Has Abstract

pub_date

2002-02-01 00:00:00

pages

E2

issue

1

eissn

1368-4973

issn

1472-3263

journal_volume

78

pub_type

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