S. Hanson et al., STD CARE IN ZAMBIA - AN EVALUATION OF THE GUIDELINES FOR CASE-MANAGEMENT THROUGH A SYNDROMIC APPROACH, International journal of STD & AIDS, 7(5), 1996, pp. 324-332
Clinical diagnosis of STDs is unreliable and therefore constitutes a p
oor basis for choice of treatment. A syndromic approach has been sugge
sted 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. T
he cure rate for GUD was 83% for female and 69% for male patients. A h
igher prevalence of syphilis in the female study population probably c
ontributed to this. It is likely that a large proportion of the treatm
ent failures were due to decreased susceptibility of Haemophilus ducre
yi 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.