%0 Journal Article
%T STD care in Zambia: an evaluation of the guidelines for case management through a syndromic approach.
%A Hanson S
%A Sunkutu RM
%A Kamanga J
%A Höjer B
%A Sandström E
%J Int J STD AIDS
%V 7
%N 5
%D Aug-Sep 1996
%M 8894821
%F 1.456
%R 10.1258/0956462961918211
%X Clinical diagnosis of STDs is unreliable and therefore constitutes a poor basis for choice of treatment. A syndromic approach has been suggested to increase effectiveness of treatment in resource poor settings. Algorithms for the treatment of STD syndromes were evaluated. A total of 436 patients were followed; cure rates were defined and estimated for genital ulcer disease (GUD), urethral and vaginal discharge. Cure rates for the discharge syndromes were high, 97-98%, for both sexes. The cure rate for GUD was 83% for female and 69% for male patients. A higher prevalence of syphilis in the female study population probably contributed to this. It is likely that a large proportion of the treatment failures were due to decreased susceptibility of Haemophilus ducreyi to trimethoprim-sulpha. The determination of cure rates met with a number of methodological problems. This makes it difficult to evaluate the algorithms as part of routine activities, as suggested earlier by WHO.