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Sexually Transmitted Diseases
Introduction Contents Post-Test References Go To Presenter Info

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

Vaginal Discharge: Algorithms (continued)

Vaginal Discharge: Algorithms diagram

Slide 68


If the prevalence of gonorrhea and chlamydia is particularly low or high, FP/MCH programs might consider one of the two approaches shown on this slide.

Among populations with low prevalence of gonorrhea and chlamydia, the client is treated initially only for vaginitis. If after seven days her discharge persists, the woman should return to the clinic. The provider then treats for cervicitis. Only at this point does the provider recommend the woman’s sexual partner be contacted for possible treatment. The woman is advised to return if the discharge continues after seven more days, when she would be referred to a higher level of care.

This model helps to avoid overtreatment of women who have only vaginitis, but it risks missing or delaying treatment for those who have cervicitis. This delay may result in serious complications. Also, this model may be particularly problematic for clients who have to travel long distances to a clinic, or are otherwise unlikely to return for follow-up treatment.

Among populations with high prevalence of gonorrhea and chlamydia, the client is treated initially for both vaginitis and cervicitis. If the discharge persists after seven days, the woman is advised to return for referral to a higher level of care. This approach overtreats to a greater degree but requires fewer trips to the clinic. Furthermore, women who do have cervicitis receive more timely treatment.

 

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