Effectiveness of syndromic management of vaginal discharge at specialized treatment center (casino) Nairobi.

Abstract

BACKGROUND: Syndromic management is a World Health Organization (WHO) strategy for the management of Sexually Transmitted Infections (STI). Diagnosis is based on identification of syndromes, which are combinations of symptoms as reported, by client and signs observed during examination. Syndromic management is recommended for STI management in developing countries especially where laboratory facilities are unavailable. Etiological diagnosis of STI is problematic in many settings. It places constraints on time, resources, costs and access to treatment. In addition, the sensitivity and specificity of available tests can vary significantly, thus, affecting negatively, the reliability of laboratory testing. OBJECTIVE: The study was aimed to determining the effectiveness of the currently recommended kit for syndromic management of vaginal discharge among women attending at specialized treatment center casino. METHODS: A quasi-experimental study (pre-post study design without a control group) was conducted from January 2012 to march 2012, a nonrandom convenience sampling was used and a total of 100 women were recruited, 3 women were not able to return for the second visit. The study used structured questionnaire pre and post treatment and laboratory methods (High vaginal swab and endocervical swab for microscopy, culture and sensitivity both on day one before treatment and day eight after treatment with the kit to measure effectiveness of the syndromic management .A kit containing 2grams of Secnidazole, 150mg of fluconazole and 1gram of Azithromycin was used as an intervention on day one. RESULTS: The results of 97 women who completed the study, showed the effectiveness of syndromic management of vaginal discharge using the current recommended kit was 79.4%.Bacterial Vaginosis was the commonest microbe found in women presenting with vaginal discharge followed by Vaginal candidiasis at 28.9%,Trichomonas vaginalis 7.2%,Staphylococcus Aureus 3.1%(probably contamination) and no growth obtained 24.7%. CONCLUSION: The effectiveness of syndromic management of abnormal vaginal discharge at specialized treatment center (Casino) using the current recommended kit was 79.4%. RECOMMENDATION: The combination kit therapy in syndromic management of vaginal discharge allows simple, fast and assured therapy with a high cure rate. Its use turns out to be cost effective and should be highly recommended especially in poor resource settings.