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Sexually Transmitted Diseases
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Goals

Section 1
Section 2
Section 3

- Topics
- Introduction
- Objectives
- Approaches
- Laboratory
- Clinical
- Syndromic
- Syndromic
- Strengths
> Weaknesses
- Accuracy
- Genital Ulcer
- Algorithm
- Urethral
- Algorithm
- Vaginal
- Vaginitis
- Cervicitis
- Algorithms
- Algorithms
- Algorithms
- Abdominal
- PID
- Algorithm
- Algorithm
- Other Issues
- Treatment
- Screening
- The Four Cs
- Resources
- HIV Testing
- Vaccination
- Preliminary
- Summary

Summary

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Section 3 - STD Management

Syndromic Approach: Weaknesses

  • Requires staff training in algorithm use

  • Results in overtreatment
    • requires larger supply of drugs

  • Partners may be contacted unnecessarily

  • Algorithms not equally accurate

Slide 57


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 district’s 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 HIV.

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.

 

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