31.4.1 Classification of patients into syndromes
Using the syndromic approach, health workers at health centres 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 health centre. At this moment you are not expected to treat STI cases either at the health post or in the community. In the health centre the patient will receive all necessary services including testing for HIV. Table 31.1 shows a modified summary version of syndromic management of the common STIs described in Section 31.3 and others. For detailed reading you can refer to the Ethiopian National Syndromic Management of STIs Guideline.
| 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 health centre |
| Candidiasis | Refer to health centre. Consider HIV-related illness if it is recurrent | ||
| Gonorrhoea Chlamydia | Refer to health centre Counsel and refer for HIV and syphilis testing Include partner tracing | ||
| Urethral discharge | Urethral discharge, dysuria, frequent urination | Gonorrhoea Chlamydia | Refer to health centre 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 health centre Promote and provide condoms Consider HIV-related illness; offer HIV testing and counselling Educate on STIs, HIV and risk reduction |
| Genital herpes | Refer to health centre | ||
| Lower abdominal pain | Vaginal discharge, fever, lower abdominal pain and tenderness | Gonorrhoea Chlamydia, | Refer to health centre. Consider HIV-related illness Consider partner tracing |
| Scrotal swelling | Pain and swelling of the scrotum | Gonorrhoea Chlamydia | Refer to health centre. Consider HIV-related illness Consider partner tracing |
| Inguinal bubo | Painful enlarged lymph nodes on the groin | Lymphogranuloma venerum (LGV) Chancroid | Refer to health centre 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 the nearest health centre for management |
31.4 Syndromic management of STIs