The use of epidemiologic mass treatment and syndrome management for sexually transmitted disease control

Background: Epidemiologic mass treatment and syndrome management are two se xually transmitted disease (STD) control strategies that are receiving incr eased attention internationally, The former is a population-based intervent ion, whereas the latter attempts to improve the quality and efficiency of c linic-based STD case management. Methods: The published literature on these subjects was reviewed. Results: Epidemiologic mass treatment refers to treatment of whole communit ies (mass treatment) or high-risk subgroups within communities (targeted pr esumptive treatment) based on high STD prevalence rates. Syndrome managemen t overcomes many obstacles to provision of quality STD case management by b asing treatment decisions on recognition of easily identifiable syndromes. Experience with application of these strategies is summarized, and their po ssible use as STD control measures in communities with similar conditions i s discussed. Conclusions: Epidemiologic mass treatment may be an effective approach to r apidly reduce STD transmission in high prevalence communities, especially w hen high-risk core groups are effectively reached. Once high prevalence rat es are brought down, however, longer term strategies, including improved ST D case management, are essential to maintain reduced rates.