Classification of patients into syndromes
Using the syndromic approach, health professionals at higher health facilities and hospitals can identify one of these syndromes and treat accordingly. The objective of introducing you to syndromic management of STIs is to help you identify and refer cases to the nearest higher health facility/hospital. At this moment you are not expected to treat STI cases either at your primary healthcare facility or in the community. In a higher health facility/hospital the patient will receive all necessary services including testing for HIV. The table below shows a summary version of syndromic management of the common STIs.
Main sexually transmitted infection syndromes.
| Syndrome | Signs and symptoms | Most common causes | Management |
|---|---|---|---|
| Vaginal discharge | Unusual vaginal discharge, vaginal itching, dysuria (pain on urination and pain during sexual intercourse) | Trichomoniasis Bacterial vaginosis | Refer to a higher health facility/hospital |
| Candidiasis | Refer to a higher health facility/hospital. Consider HIV-related illness if it is recurrent | ||
| Gonorrhoea Chlamydia |
Refer to a higher health facility/hospital Counsel and refer for HIV and syphilis testing Include partner tracing |
||
| Urethral discharge | Urethral discharge, dysuria, frequent urination | Gonorrhoea Chlamydia |
Refer to a higher health facility/hospital Offer HIV testing and counselling and refer for syphilis testing Consider HIV-related illness Consider partner tracing |
| Genital ulcer | Genital sore | Syphilis, Chancroid |
Refer to a higher health facility/hospital Promote and provide condoms Consider HIV-related illness; offer HIV testing and counselling Educate on STIs, HIV and risk reduction |
| Genital herpes | Refer to a higher health facility/hospital | ||
| Lower abdominal pain | Vaginal discharge, fever, lower abdominal pain and tenderness | Gonorrhoea Chlamydia, |
Refer to a higher health facility/hospital. Consider HIV-related illness Consider partner tracing |
| Scrotal swelling | Pain and swelling of the scrotum | Gonorrhoea Chlamydia |
Refer to a higher health facility/hospital. Consider HIV-related illness Consider partner tracing |
| Inguinal bubo | Painful enlarged lymph nodes on the groin | Lymphogranuloma venerum (LGV) Chancroid |
Refer to a higher health facility/hospital Consider HIV-related illness; offer HIV testing and counselling Educate on STIs, HIV and risk reduction |
| Neonatal conjunctivitis | Swollen eyelids, eye discharge in newborns and infants | Gonorrhoea Chlamydia | Refer to a higher health facility/hospital |