SYNDROMIC APPROACH TO STD CASE-MANAGEMENT - WHERE DO WE GO FROM HERE

In the absence of aetiological tests for the diagnosis of individual s exually transmitted diseases (STD), the syndromic approach has been de veloped as an effective and appropriate case management strategy. Algo rithms provide guidance to healthcare workers and ensure standardised approaches to case management. The syndromic approach, utilising curre ntly available algorithms, works well in the management of people with symptomatic urethritis, genital ulcer disease, and vaginitis. Owing t o the frequently asymptomatic nature of gonococcal and/or chlamydial c ervicitis, and the lack of specific defining risk factors and/or signs and symptoms, the syndromic approach performs less well in the identi fication and management of women with cervicitis. The syndromic approa ch can and should be adopted for the management of patients with ureth ral discharge, genital ulceration, vaginal discharge, and cervical sig ns. Further research is needed to improve the identification and manag ement of cervical infections; to guide policy makers in selecting the most appropriate disease control strategy; to improve utilisation of a vailable and future tests; to develop affordable, rapid, and simple di agnostic tests; and to develop STD vaccines.