Efficacy of syndromic management measured as symptomatic improvement in females with vaginal discharge syndrome

Abstract

Background:In spite of a few shortcomings such as over diagnosis and over treatment, syndromic management is a recommended practice in India for sexually transmitted infections (STIs). This study tries to find out the efficacy of syndromic management measured as symptomatic improvement in females with vaginal discharge syndrome.Objective:The objective of the study is to find out the effectiveness of syndromic management in terms of symptomatic improvement among females with vaginal discharge syndrome.Materials and Methods:A longitudinal study was conducted in Gynecology Department of Tertiary Care Hospital including 180 symptomatic females having vaginal discharge syndrome. Demographic profile, presenting complaints, menstrual history, obstetric history, partner history, and contraceptive history were noted. This was followed by clinical examination and specimen collection for laboratory tests and blood tests to find out type of STI including viral STI such as human immunodeficiency virus (HIV), herpes simplex virus (HSV), and hepatitis B surface antigen (HBsAg). Treatment was given according to syndromic management on the same day. All the participants were asked to come for follow-up after 15 days and their improvement in symptoms was noted as complete improvement, some improvement or no improvement on a five point scale.Results:63.9% cases showed complete improvement, while 36.1% showed some improvement. None of the patients was without any improvement. Vaginal discharge syndrome was most common between 20 and 30 years (43.4%), and 67.8% of symptomatic females with vaginal discharge syndrome belonged to the lower socioeconomic group. HSV infection was the most common (15%) associated viral infection with vaginal discharge syndrome, while hepatitis B infection was the least common (0.5%). HIV was reactive in 2.8% cases only.Conclusion:Syndromic management was found to be effective in relieving symptoms in most of the cases of vaginal discharge syndrome.

Sexually transmitted infections or reproductive tract infections prevalence and treatment efficacy of syndromic approach in reproductive age group women attending gynaecological out-patient department

“…In this study syndromic management effective in 65.39% women of reproductive age group. Chauhan et al and Singh et al showed syndromic management effective in relieving symptoms in most of the cases which is comparable to this study 1,17.…”

Accuracy of self-collected versus healthcare worker collected specimens for diagnosing sexually transmitted infections: an updated systematic review and meta-analysis

“…As such, asymptomatic individuals continue to spread infection and become susceptible to long term STI complications. Syndromic management often promotes over-diagnosing and over-treating because treatment is issued often targeting the most common STI causative pathogens instead of a speci c pathogen (13,14). As such Murewanhena et al (14) suggest a shift from syndromic management of STIs to a more pathogen speci c diagnosis and treatment of STIs.…”

Accuracy of self-collected versus healthcare worker collected specimens for diagnosing sexually transmitted infections in females: an updated systematic review and meta-analysis

“…As such, asymptomatic individuals continue to spread infection and become susceptible to long term STI complications. Syndromic management often promotes over-diagnosing and over-treating because treatment is issued often targeting the most common STI causative pathogens instead of a specific pathogen 13 , 14 . As such Murewanhena et al 14 suggest a shift from syndromic management of STIs to a more pathogen specific diagnosis and treatment of STIs.…”