LETTER TO EDITOR
|Year : 2012 | Volume
| Issue : 2 | Page : 146-147
Study of syndromic management approach in the management of sexually transmitted diseases in rural population
Shitij S Goel, Shelly S Goel
Department of Dermatology, School of Medical Science & Research, Sharda University, Greater Noida, UP, India
|Date of Web Publication||9-Oct-2012|
Shitij S Goel
Department of Dermatology, School of Medical Sciences & Research,Sharda University, Greater Noida-201306, UP
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Goel SS, Goel SS. Study of syndromic management approach in the management of sexually transmitted diseases in rural population. Indian J Sex Transm Dis 2012;33:146-7
|How to cite this URL:|
Goel SS, Goel SS. Study of syndromic management approach in the management of sexually transmitted diseases in rural population. Indian J Sex Transm Dis [serial online] 2012 [cited 2019 Dec 16];33:146-7. Available from: http://www.ijstd.org/text.asp?2012/33/2/146/102137
Sexually transmitted diseases (STDs) are prevalent worldwide. In 1991, Syndromic management approach was developed by World Health Organization (WHO) to address the limitation of etiological and presumptive diagnosis. Syndromic approach uses clinical algorithms based on an STD syndrome, constellation of symptoms and clinical signs, to determine therapy.  The present study has been conducted to analyze the effectiveness of Syndromic management methodology in various STD-related syndromes and to observe the side effects arising out of syndromic management approach.
A total of 160 cases of STDs residing mainly in rural area, attending STD clinic of a teaching hospital, were studied. Details including sexual history were recorded as per the performa and examination was done to assess which syndrome the patient has. All the patients were treated as per Syndromic management guidelines of National Aids Control Organization. Patients were then followed after completion of treatment.
In the present study, highest number of patients (39.37%) was seen in the age group of 21-30 years. This being the most active phase of sexual life, S.D.Chaudhary et al. also reported maximum no. of patients in this age group in their study.  Females (60.3%) outnumbered males (39.37%) in the present study by ratio of 1.53:1. The most common syndrome observed in this study was vaginal discharge which was found in 70 (43.75%) patients. 49 patients (30.62%) presented with genital ulcer syndrome which was followed by lower abdominal pain in 20 (12.5%) and urethral discharge in 18 patients (11.25%). Only 3 patients had inguinal bubo. R George et al. also observed vaginal discharge as the most common syndrome in their study.  Incidence of asymptomatic infections is high in females and may lead to increased incidence of vaginal discharge in them.
Overall 136 out of 160 patients (85%) showed good response with Syndromic treatment. In urethral discharge syndrome, 16 patients out of total 18 had no discharge after the treatment. Good response was also observed in vaginal discharge group, where 65 out of 70 patients improved with the treatment (92.8%). Similarly syndromes of lower abdominal pain and inguinal swelling also showed 90 and 100% improvement with the Syndromic management treatment.
In genital ulcer herpetic group, all 20 patients improved with the treatment (100%). But in non-herpetic genital ulcer syndrome group, only 14 patients out of 29 responded (48%) while rest did not improve. When this group was clinically divided into individual STDs, we observed that patients who showed poor response had either genital herpes or candidial balanoposthitis with superficial circumferential erosion / ulceration.
Drugs used in Syndromic management approach were well tolerated. Only 5 patients (3.13%) could not tolerate the drugs well. Overall 136 (85%) patients were satisfied with Syndromic management approach.
The present study shows that Syndromic approach is indeed very effective and safe in treatment of STDs. Excellent results were observed in all syndromes except in genital ulcer syndrome. Presentations in genital ulcerative diseases are relatively more variable and complex to fit into a syndrome. Hence health care providers should give more attention regarding the application of genital ulcer syndrome flow chart.
| Acknowledgment|| |
Dr. Nitin Vora, Professor, Dermatology & Venerology, B.J. Medical College, Ahmedabad.
| References|| |
|1.||Training modules towards management of STD patients, developed by National Aids Control Society, New Delhi in association with World Health Organization. |
|2.||Chaudhary SD. Pattern of STDs in Rohtak. Indian J Sex Transm Dis 1988;9:4-7. |
|3.||George R, Thomas K, Thyagarajan SP, Jeyaseelan L, Peedicayil A, Jeyaseelan V, et al. Genital syndromes and Syndromic management of vaginal discharge in a community setting. Int J STD AIDS 2004;15:367-70. |