Syndromic management of sexually transmitted diseases at primary care level, Mozambique

Sex Transm Infect. 2002 Feb;78(1):E2. doi: 10.1136/sti.78.1.e2.

Abstract

Objective: To assess STD management in primary healthcare facilities where STD clinics and syndromic management guidelines had been introduced.

Methods: In 26 health facilities in selected sites, we observed management of all STD patients presenting in the adult general or STD clinic. We assessed the referral system by analysing patient registers.

Results: 408 STD patients (65% in STD and 35% in general clinics) were observed. 70% were women. Women were examined less (26% against 75%, p<0.0001), had laboratory tests ordered more (74% against 45%, p=0.0002), were more often diagnosed syndromically (57% against 38%, p=0.008), and received less advice on condom use (19% against 87%, p<0.001) and contact treatment (47% against 81%, p=0.04). Examination, laboratory requests, diagnosis, and treatment were not significantly different in the STD and general clinic. Health education was better in the STD clinic (condom advice 47% against 8%, p <0.001). Only 41% of referred patients presented to the STD clinic.

Conclusions: The better performance of STD clinics in health education was offset by high referral losses. A proposed integration of STD treatment into general outpatient clinics and better implementation of syndromic management and health education should improve STD case management at primary level in Mozambique.

MeSH terms

  • Adult
  • Ambulatory Care / organization & administration
  • Condoms / statistics & numerical data
  • Female
  • Health Education / methods
  • Health Promotion / methods
  • Humans
  • Male
  • Mozambique
  • Primary Health Care / organization & administration
  • Sexually Transmitted Diseases / therapy*