Pre and post treatment symptomatic assessment of patient with STI receiving syndromic treatment

Abstract

Introduction:The aim of this study is to accesses the use of the syndromic approach towards managing sexually transmitted infections (STIs) in north western part of India and to make recommendations about the strengths and weakness of syndromic management algorithms and to determine if evidence supports its continued use. Materials and Methods: Total of 412 patients diagnosed as STI based on clinical and physical examination were treated based on syndromic approach and finally 240 patients were recruited in the study. Diagnosis was made based on signs, symptoms and examination. Every symptomatic patient suggestive of STI was managed on the basis of algorithms of the syndrome approach and patients were again followed up after completion of treatment for assessment of clinical improvement/deterioration of signs and symptoms. Results: Vaginal discharge (48.5%, 194 out of 400) followed by lower abdominal pain (46.75%, 187 out of 400) were the most common complaints. On cervico-vaginal smear cytology, 31.70%, 12.19% and 4.87% tested positive for bacterial vaginosis, leptothrix and candidiasis respectively. Syndromic approach for patients of STIs with symptoms of pain abdomen, white discharge P/V and itching P/V are statistically highly significant (Chi-Square Value~86.44 and its p value <0.0001) but for genital ulcer and urinary tract infection is statistically not significant. (Chi-Square Value~0.55 and its p value is>0.05). Conclusion: Syndromic management may be an effective method for clinical management of symptomatic STIs in low resource setting as illustrated in our finding. But further research is needed to determine the cost-benefit ratio of introducing laboratorybased screening into a comprehensive public health program for the control of commonly seen STIs in populations at risk for STIs.