Low effectiveness of syndromic treatment services for curable sexually transmitted infections in rural South Africa.

Sexually Transmitted Infections
R G WhiteRichard J Hayes

Abstract

Syndromic sexually transmitted infection (STI) treatment remains a cost-saving HIV prevention intervention in many countries in Africa. We estimate the effectiveness of syndromic treatment for curable STIs in rural KwaZulu-Natal, South Africa, and the trend in STI prevalences before and after the introduction of syndromic treatment in 1995. Data were available from various clinical studies, surveys of public and private health providers, the general population and women attending antenatal, family planning and child immunisation clinics in rural northern KwaZulu-Natal between 1987 and 2004. Overall effectiveness was defined as the estimated proportion of the annual number of symptomatic curable STI episodes cured by syndromic treatment based on separate estimates for six curable STI aetiologies by gender. Median overall effectiveness was 13.1% (95% CI 8.9 to 17.8%) of symptomatic curable STI episodes cured. Effectiveness increased to 25.0% (95% CI 17.3 to 33.8%), 47.6% (95% CI 44.5 to 50.8%) or 14.3% (95% CI 9.9 to 19.4%) if 100% treatment seeking, 100% correct treatment provision or 100% cure were assumed, respectively. Time-trends were difficult to assess formally but there was little evidence of decreasing STI prevalences. I...Continue Reading

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Citations

Dec 16, 2009·BMC Public Health·Omar GalárragaStefano M Bertozzi
Jul 17, 2010·PloS One·Carol S CamlinRachel C Snow
Apr 1, 2014·BMC Infectious Diseases·Mathys J RedelinghuysMarleen M Kock
Dec 15, 2010·Sexual & Reproductive Healthcare : Official Journal of the Swedish Association of Midwives·Leigh F JohnsonDavid J Coetzee
Apr 17, 2016·Sexually Transmitted Infections·Nigel J GarrettAdrian Mindel
Jun 15, 2010·Current Opinion in HIV and AIDS·Elizabeth HamlynSarah Fidler
Sep 2, 2020·Antimicrobial Agents and Chemotherapy·Liteboho D MadunaRemco P H Peters
Mar 16, 2021·The Cochrane Database of Systematic Reviews·Jael ObieroCharles S Wiysonge

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