Evaluation of syndromic management guidelines for treatment of sexually transmitted infections in South African women

dc.contributor.authorVan der Eem, Lisette
dc.contributor.authorDubbink, Jan Henk
dc.contributor.authorStruthers, Helen E.
dc.contributor.authorMcIntyre, James A.
dc.contributor.authorOuburg, Sander
dc.contributor.authorMorre, Servaas A.
dc.contributor.authorKock, Martha Magdalena
dc.contributor.authorPeters, Remco P.H.
dc.date.accessioned2017-03-27T07:38:40Z
dc.date.issued2016-09
dc.description.abstractOBJECTIVE : To evaluate performance of three different guidelines for the management of vaginal discharge syndrome (VDS) for women living in a rural setting in South Africa. METHODS : We conducted a secondary analysis of data from a cross-sectional study in Mopani District, South Africa. The 2015 and 2008 guidelines of the South African Department of Health (DoH) and the most recent WHO guidelines were evaluated for adequate treatment of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis infection. RESULTS : Of the 489 women included in this analysis, 171 (35%) presented with VDS according to the DoH and 146 (30%) per WHO definition of VDS respectively. Fourty-two (56%) of the women with VDS would be treated adequately for these STI when using the 2015 DoH guideline, whereas 76% (p=0.01) and 64% (p=0.35) would receive adequate treatment with the 2008 DoH and WHO guidelines respectively. Of the symptomatic women who tested negative for all four STI, STI treatment would have been indicated for 36% as per 2015 DoH guideline compared to 69% (p<0.001) respectively 67% (p<0.001) per 2008 DoH and WHO guidelines. CONCLUSION : We confirm that a considerable proportion of symptomatic women infected with these common curable STI would receive adequate treatment when using a syndromic management approach, and that significant differences exist between the three guidelines. Furthermore many symptomatic women without these STI receive broad-spectrum antibiotics. Therefore innovative approaches are warranted to improve STI control in settings with syndromic approach.en_ZA
dc.description.departmentMedical Microbiologyen_ZA
dc.description.embargo2017-09-30
dc.description.librarianhb2017en_ZA
dc.description.sponsorshipThis work was supported by the Dutch Society for Tropical Medicine (NVTG), the Netherlands, and TubaScan Ltd., the Netherlands. The Anova Health Institute is supported by the US President’s Emergency Plan for AIDS Relief program via the US Agency for International Development under Cooperative Agreement No. AID-674-A- 12-00015.en_ZA
dc.description.urihttp://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-3156en_ZA
dc.identifier.citationVan der Eem, L, Dubbink, JH, Struthers, HE, McIntyre, JA, Ouburg, S, Morré, SA, Kock, MM & Peters, RPH 2016, 'Evaluation of syndromic management guidelines for treatment of sexually transmitted infections in South African women', Tropical Medicine and International Health, vol. 21, no. 9, pp. 1138-1146.en_ZA
dc.identifier.issn1360-2276 (print)
dc.identifier.issn1365-3156 (online)
dc.identifier.other10.1111/tmi.12742
dc.identifier.urihttp://hdl.handle.net/2263/59534
dc.language.isoenen_ZA
dc.publisherWileyen_ZA
dc.rights© 2016 John Wiley and Sons, Ltd. This is the pre-peer reviewed version of the following article : Evaluation of syndromic management guidelines for treatment of sexually transmitted infections in South African women, Tropical Medicine and International Health, vol. 21, no. 9, pp. 1138-1146, 2016. doi : 10.1111/tmi.12742. The definite version is available at : http://onlinelibrary.wiley.comjournal/10.1111/(ISSN)1365-3156.en_ZA
dc.subjectSyndromic managementen_ZA
dc.subjectSexually transmitted infection (STI)en_ZA
dc.subjectLow-resource settingen_ZA
dc.subjectSouth Africa (SA)en_ZA
dc.subjectVaginal discharge syndrome (VDS)en_ZA
dc.titleEvaluation of syndromic management guidelines for treatment of sexually transmitted infections in South African womenen_ZA
dc.typePostprint Articleen_ZA

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