- Requires staff training in algorithm use
- Results in overtreatment
- requires larger supply of drugs
- Partners may be contacted unnecessarily
- Algorithms not equally accurate
Syndromic management has several weaknesses as well.
Staff must be trained in the overall approach and in the details
of the algorithms they may use. For proper treatment, providers
must follow algorithms precisely, which requires staff supervision.
This approach typically results in overtreatment, since clients
are generally treated for all possible causes of the syndrome.
Hence, clients with only a single infection may be treated for
multiple infections. Treatment for multiple infections requires
more drugs than treatment for a single infection. This extra
supply of drugs can be expensive and can draw excessively on
a country or districts overall drug supplies.
Some experts, however, point out that in the case of STDs,
it may be preferable to overtreat than to leave a patient with
an untreated infection. This infection can result in serious
complications, which will be expensive to treat, and can contribute
to the further spread of the disease. This is especially true
in areas with high prevalence rates of certain STDs, including
Another weakness of this approach concerns partners being contacted
unnecessarily. With most syndromes, patients diagnosed with
an STD are advised to notify their partners that they may be
infected as well. With the vaginal discharge syndrome, however,
a woman may have an infection that is not due to sexual contact.
Hence, she would unnecessarily notify her partner of a possible
STD. Since having an STD can imply infidelity, unnecessary notification
could jeopardize the relationship and even put the woman at
risk of physical violence.
Finally, this approach works well with some syndromes but not
as well with others. Thus, algorithms used for the various syndromes
are not equally accurate.