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 womans 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