Efficacy of conventional pharmacotherapy of syndromic management of STIs: a two year cross-sectional prospective study
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20182692Keywords:
Antibiotics resistance, Lower Abdomen Pain (LAP), Vaginal Discharge (Vag Ds)Abstract
Background: Syndromic management has been the centre for treating STIs in a resource constraint facility since its introduction by WHO and CDC more than a decade back. Recently there has been lots of debate on its empirical use in an era of antibiotics resistance and ever-changing varieties of microorganisms causing these infections. Present study evaluated the efficacy of pharmacotherapy of syndromic management measured by symptomatic improvement in females presenting with STIs.
Methods: It was a two year cross-sectional prospective study including all the females of STI syndromes, attending Gynecology OPD of Sanjay Gandhi Memorial Hospital and results were assessed in pharmacology department, Gajra Raja medical college Gwalior from Jan 2015 to December 2016.
Results: During the study period total of 24,556 patients attended the Gynecology OPD out of which 8562 patients presented with different STI syndromes. Lower abdomen pain with vaginal discharge was the most common symptom while Ulcerative lesions were the least common complaint. Maximum recurrence was seen in patients of vaginal discharge and itching followed by PID syndrome which responded to second line of drugs.
Conclusions: Syndromic Management of STIs is an old approach to deal with a very common gynecological problem and needs to be reviewed in an era of wide spread antibiotics resistance.
Metrics
References
World Health Organization. Global prevalence and incidence of selected curable sexually transmitted infections: overviews and estimates. WHO/HIV_AIDS/2001-02. Geneva: WHO; 2001. Available at: http://www.who.int/hiv/pub/sti/who_hiv_aids_2001.02.pdf .
Bang R, Bang A. Why women hide the rural women's viewpoints on reproductive tract infections. MANUSHI. A J Women and Society. 1992;69.
Oomman N. A decade of research on reproductive tract infection and other gynaecological morbidity in India: What we know and what we do not know. Women’s Reproductive Health in India, Jaipur, India: Rawat Publications. 2000:236-279.
Garg S, Sharma N, Bhalla P, Sahay R, Saha R, Raina U, et al. Reproductive morbidity in an Indian urban slum: need for health action. Sexually transmitted infections. 2002 Feb 1;78(1):68-9.
Wasserheit JN, Aral SO. The dynamic topology of sexually transmitted disease epidemics: implications for prevention strategies. J Infect Dis. 1996;174(S):S201-13.
Das NP, Shah U. Understanding women reproductive health needs in urban slums: a rapid assessment; 2001.
Das NP, Shah U. Understanding Women's Reproductive Health Needs in the Rural Areas of Gujarat. Reproductive Child Health. 2002:191.
Das NP, Shah U. A study of reproductive health problems among men and women in urban slums with special reference to sexually transmitted infections. Population Research Centre, Faculty of Science, Maharaja Sayajirao University of Baroda; 2007.
National AIDS Control Organization. National Guidelines on Prevention, Management and Control of Reproductive tract Infections including Sexually Transmitted Infections. New Delhi, India: Ministry of Health and Family Welfare, Government of India; 2007.
World Health Organization. Guidelines for the Management of Sexually Transmitted Infections. Geneva, Switzerland: World Health Organization; 2003:1-60.
Choudhry S, Ramachandran VG, Das S, Bhattacharya SN, Mogha NS. Pattern of sexually transmitted infections and performance of syndromic management against etiological diagnosis in patients attending the sexually transmitted infection clinic of a tertiary care hospital. Indian J Sex Transm Dis. 2010;31:104-8.
Yin YP, Wu Z, Lin C, Guan J, Wen Y, Li L, et al. Syndromic and laboratory diagnosis of sexually transmitted infection: A comparative study in China. Int J STD AIDS. 2008;19:381-4.
Shah M, Deshmukh S, Patel SV, Mehta K, Marfatia Y. Validation of vaginal discharge syndrome among pregnant women attending obstetrics clinic, in the tertiary hospital of Western India. Indian J Sex Transm Dis. 2014;35:118-23.
Chauhan V, Shah M, Thakkar S, Patel SV, Marfatiya Y. Sexually transmitted infections in women: Assessment of clinical pattern of common STIs and evaluation of syndromic approach in regional STI centre of Gujarat. Indian Dermatol Online J. 2014;5:1-5.
National AIDS Control Organisation. Combating HIV/AIDS in India 2001-2002. New Delhi: NACO, Ministry of Health and Family Welfare, Government of India.
Centers for Disease Control and Prevention. MMWR Series, Recommendations and Reports. Sexually Transmitted Diseases Treatment Guidelines. 2015;64(3). Available at: https://www.cdc.gov/mmwr/pdf/rr/rr6403.pdf
Panda SC, Sarangi L, Bebartta D. Prevalence of RTI/STI among women of reproductive age in district Sundergarh (Orissa). Indian J for the Pract Doc. 2007;4(1):2007-03-2007-04.
Ranjan R, Sharma AK, Mehta G. Evaluation of diagnostic algorithm for reproductive tract infections among married women. Ind J Comm Med. 2003;28(2):2003-04-2003-06.
Zurayk H, Khattab H, Younis N. Comparing women’s reports with medical diagnosis of reproductive morbidity condition in rural Egypt. Stud Fam Plann. 1995;26:14-21.
Wasserheit JN, Harris JR, Chakraborty J, Kay BA, Mason KJ. Reproductive tract infections in a family planning population in rural Bangladesh. Studies in family planning. 1989 Mar 1;20(2):69-80.
Nandan D, Misra SK, Sharma A. Estimation of prevalence of RTIs/STIs among women of reproductive age group in district Agra. Ind J Comm Med. 2002;27(3):2002-07-2002-09.
Mani G. Prevalence of reproductive tract infections among rural married women in Tamil Nadu, India: A community based study. J Pioneer Med Sci. 2014;4(1):18-24.
Jindal N, Aggrawal A, Gill P. Community based study of reproductive tract infections, among the rural population of Punjab, India. Ind J Comm Med. 2009;34(4):359-61.
Kosambiya JK, Desai VK, Bhardwaj P. RTI/STI prevalence among urban and rural women of Surat: A community based study. Indian J Sex Transm Dis. 2009;30:89-93.
Sharma S, Gupta BP. The prevalence of reproductive tract infections and sexually transmitted diseases among married women in the reproductive age group in a rural area. Indian J Comm Med. 2009;34:63-5.
Rathore M, Swami SS, Gupta BL. Community based study of self-reported morbidity of reproductive tract among women of reproductive age in rural areas of Rajasthan. Indian J Comm Med. 2003;28:117-21.
Singh MM, Devi R, Garg S, Mehra M. Effectiveness of syndromic approach in management of reproductive tract infections in women. Indian J Med Sci. 2001;55:209-14.
Thakur JS, Swami HM, Bhatia SP. Efficacy of syndromic approach in management of reproductive tract infections and associated difficulties in a rural area of Chandigarh. Indian J Community Med. 2002;27:77-9.
Hawkes S, Morison L, Foster S, Gausia K, Chakraborty J, Peeling RW. Reproductive tract infections in women in low income, low prevalence situations: assessment of syndromic management in Matlab, Bangladesh. Lancet 1999;354:1776-81.
Wang Q, Yang P, Zhong M, Wang G. Validation of diagnostic algorithms for syndromic management of sexually transmitted disease. Chin Med J. 2003;116:181-6.
Aggarwal AK, Kumar R. Syndromic management of vaginal discharge and pelvic inflammatory disease among women in a rural community of Haryana, India: agreement of symptoms enquiry with clinical diagnosis. J Commun Dis. 2004;36:1-11.
Wilkinson D, Connolly A-M, Harrison A, et al. Sexually transmitted disease syndromes in rural South Africa: results from health facility surveillance. Sex Transm Dis. 1998;25:20-3.
Moodley P, Sturm PD, Connolly C, Sturm AW. Identification of women at high STD risk among STD clinic attendees: implications for STD programmes. Int J of STD & AIDS. 2003 Aug 1;14(8):526-31.
Vuylsteke B. Current status of syndromic management of sexually transmitted infections in developing countries. Sex Transm Infect. 2004;80:333-4.