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.

Table 31.1  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 vaginosisRefer 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 tendernessGonorrhoea Chlamydia,

Refer to health centre. Consider HIV-related illness

Consider partner tracing

Scrotal swelling Pain and swelling of the scrotumGonorrhoea Chlamydia

Refer to health centre. Consider HIV-related illness

Consider partner tracing

Inguinal bubo Painful enlarged lymph nodes on the groinLymphogranuloma 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 infantsGonorrhoea Chlamydia Refer to the nearest health centre for management

31.4  Syndromic management of STIs

31.4.2  Treatment and management of STI syndromes