LETTER TO EDITOR
|Year : 2011 | Volume
| Issue : 2 | Page : 136-137
Syndromic management of STDs in a male health clinic in a primary health care setting
Karun D Sharma1, Yuvaraj B Chavan2, Radha Y Aras3, Deepak S Khismatrao4
1 Department of Community Medicine, G.S.L Medical College, Rajahmundry, Andhra Pradesh, India
2 Department of Community Medicine, Seth G.S Medical College, Mumbai, India
3 Department of Community Medicine, Yenepoya Medical College, Mangalore, India
4 Department of Community Medicine, Smt. Kashibai Navale Medical College, Pune, India
|Date of Web Publication||26-Sep-2011|
Karun D Sharma
Department of Community Medicine, G.S.L Medical College, NH 5, Lakshmipuram, Rajahmundry, Andhra Pradesh - 533 296
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sharma KD, Chavan YB, Aras RY, Khismatrao DS. Syndromic management of STDs in a male health clinic in a primary health care setting. Indian J Sex Transm Dis 2011;32:136-7
|How to cite this URL:|
Sharma KD, Chavan YB, Aras RY, Khismatrao DS. Syndromic management of STDs in a male health clinic in a primary health care setting. Indian J Sex Transm Dis [serial online] 2011 [cited 2020 Jun 4];32:136-7. Available from: http://www.ijstd.org/text.asp?2011/32/2/136/85430
To encourage male involvement in HIV/STI (human immunodeficiency virus/sexually transmitted infections) risk reduction, the RISHTA (Research and Intervention in Sexual Health Theory to Action) project was established at a population research institute in Mumbai. The project developed a Male Health Clinic (MHC) at a government urban health center (UHC) in a slum area in northeast Mumbai to provide clinic-based intervention. The clinic aimed at providing treatment and counseling services to patients with general complaints as well as complaints related to STI through medical officers who had been trained in the syndromic management of STI. In this study we assessed the performance of the MHC with respect to the syndromic management of STI. The case sheets of the patients attending the clinic were reviewed. The study sample comprised all patients attending the clinic from April 2004 to September 2005.
A total of 1587 patients attended the MHC during the study period; among them 5.8% (92/1587) were patients with STI. Fifty percent (46/92) of the these patients presented with genital ulcer disease, 25% (23/92) with scrotal swelling, 15.2% (14/92) with urethral discharge, 5.4% (5/92) with inguinal bubo, and 4.4% (4/92) with warts; 11% (10/92) had multiple STDs. An earlier study has reported urethral discharge as the most frequent syndrome (43%) in male STD patients, followed by genital ulcer (24%) and genital warts (11%). 
The overall cure rate for STD was 51.1% (47/92). The highest cure rate of 71.4% (10/14) was seen in urethral discharge, followed by 60% (3/5) in inguinal bubo, 47.8% for both genital ulcer disease (22/46) and scrotal swelling (11/23), and 25% (1/4) for warts.
In our study, we found that the STD treatment protocols were followed in 67.4% (62/92) of the patients; in contrast, a study from Chennai reported only 10% adherence to treatment protocols.  For individual diseases, the treatment protocol was followed in 100% (4/4) cases of warts, in 71.4% (10/14) cases of urethral discharge, in 69.6% (32/46) cases of genital ulcer disease, in 60% (3/5) cases of inguinal bubo, and in 56.5% (13/23) cases of scrotal swelling. It can be seen that protocols requiring multiple visits and involving detailed physical examination (such as for inguinal bubo and scrotal swelling) were followed in a lower proportion of patients.
The condom promotion rate in our study was 83.7% (77/92) among STD patients. The study in Chennai found lower rates of condom promotion (30%) among STD clinic attendees. 
The partner notification rate in our study was 20.7% (19/92). The study in Chennai reported higher rates of partner notification (27%) among STD clinic attendees.  Of the 19 partners notified in our study, 7 attended the clinic for examination and treatment, while 12 were provided treatment on the basis of symptoms reported by their partners.
The referral rate to Integrated Counseling and Testing Centre (ICTC) for STD patients was 38% (35/92).
To ensure that the treatment protocols are adhered to in all patients we recommend periodic training of medical officers in the syndromic management of STD. It is also proposed to establish a female health clinic (FHC) to ensure 100% partner notification and treatment.
| Acknowledgment|| |
The authors express their deep and sincere thanks to Professor Stephen L. Schensul, Director, Center for Community Health Studies, University of Connecticut Health Center, Farmington, Connecticut; Dr Sharad Narvekar, Project Coordinator, RISHTA project; Dr Niranjan Sagrugutti, former Reader, IIPS; and all the staff of the RISHTA project for their support during this study.
| References|| |
|1.||Ghauri AK, Shah SA, Memon MA, Abbas SQ. Syndromic Management of STIs in Public Sector Hospitals. Int Conf AIDS. 2004;15:C11575. Available from: http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102277370.html. [Last cited on 2011 Apr 2]. |
|2.||Mertens TE, Smith GD, Kantharaj K, Mugrditchian D, Radhakrishnan KM. Observations of sexually transmitted disease consultations in India. Public Health 1998;112:123-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9581455. [last cited on 2011 Mar 25]. |