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Evaluating the utility of syndromic case management for three sexually transmitted infections in women visiting hospitals in Delhi, India.
Sci Rep. 2017 05 03; 7(1):1465.SR

Abstract

Utility of syndromic case management (SCM) in women visiting obstetrics & gynecology department needs to be evaluated as it is subjective and imperfect. Consequently, antibiotic resistance has accelerated along with increased risk of infection to the partners. To understand the effectiveness and/or inadequacies of SCM, 11000 women were recruited and examined by clinicians for infection by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Bacterial vaginosis (BV) and others. Amongst these patients, 1797 (16.3%) reported vaginal discharge (VD). Other symptoms included: vaginitis (97%), cervicitis (75%), genital ulcers (60%), abnormal vaginal discharge (55%) and lower abdominal pain (48%). The patients were treated for single or co-infections using pre-packed National Aids Control Program III STI/RTI Kits. However, based on PCR diagnostics, 1453/1797 (81%) subjects were uninfected for NG/TV/CT. Amongst 344 (19%) infected patients, 257 (75%) carried infection with single pathogen (TV/NG/CT) while 87/344 (25%) were co-infected with multiple pathogens. Prevalence of TV, NG & CT was 4%, 7% and 8% respectively. Co-infection with CT + NG was highest, 51% (44/87), whereas, co-infection with CT + TV was 21% and NG + TV was 18% while co-infection with all three pathogens was 1.3%. We conclude that SCM is imprecise and successful intervention requires accurate and confirmatory diagnostic approach.

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Authors+Show Affiliations

Sonkar SC
Medical Biotechnology Laboratory, Dr. B. R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, India.
Wasnik K
Medical Biotechnology Laboratory, Dr. B. R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, India.
Kumar A
Department of Obstetrics & Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Sharma V
National Institute of Cancer Prevention and Research, Formerly Institute of Cytology and Preventive Oncology (Indian Council of Medical Research), Noida, Uttar Pradesh, India.
Mittal P
Department of Obstetrics & Gynecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Mishra PK
Medical Biotechnology Laboratory, Dr. B. R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, India.
Bharadwaj M
National Institute of Cancer Prevention and Research, Formerly Institute of Cytology and Preventive Oncology (Indian Council of Medical Research), Noida, Uttar Pradesh, India.
Saluja D
Medical Biotechnology Laboratory, Dr. B. R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, India. dsalujach59@gmail.com.

MeSH

AdolescentAdultAnti-Bacterial AgentsCase ManagementChlamydia InfectionsChlamydia trachomatisCoinfectionEmpirical ResearchFemaleGardnerella vaginalisGonorrheaHospitalsHumansIndiaMiddle AgedNeisseria gonorrhoeaeOffice VisitsSexually Transmitted DiseasesTreatment OutcomeTrichomonas VaginitisTrichomonas vaginalisVaginosis, Bacterial

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28469158

Citation

Sonkar, Subash Chandra, et al. "Evaluating the Utility of Syndromic Case Management for Three Sexually Transmitted Infections in Women Visiting Hospitals in Delhi, India." Scientific Reports, vol. 7, no. 1, 2017, p. 1465.
Sonkar SC, Wasnik K, Kumar A, et al. Evaluating the utility of syndromic case management for three sexually transmitted infections in women visiting hospitals in Delhi, India. Sci Rep. 2017;7(1):1465.
Sonkar, S. C., Wasnik, K., Kumar, A., Sharma, V., Mittal, P., Mishra, P. K., Bharadwaj, M., & Saluja, D. (2017). Evaluating the utility of syndromic case management for three sexually transmitted infections in women visiting hospitals in Delhi, India. Scientific Reports, 7(1), 1465. https://doi.org/10.1038/s41598-017-01422-y
Sonkar SC, et al. Evaluating the Utility of Syndromic Case Management for Three Sexually Transmitted Infections in Women Visiting Hospitals in Delhi, India. Sci Rep. 2017 05 3;7(1):1465. PubMed PMID: 28469158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluating the utility of syndromic case management for three sexually transmitted infections in women visiting hospitals in Delhi, India. AU - Sonkar,Subash Chandra, AU - Wasnik,Kirti, AU - Kumar,Anita, AU - Sharma,Vineeta, AU - Mittal,Pratima, AU - Mishra,Prashant Kumar, AU - Bharadwaj,Mausumi, AU - Saluja,Daman, Y1 - 2017/05/03/ PY - 2016/10/11/received PY - 2017/03/28/accepted PY - 2017/5/5/entrez PY - 2017/5/5/pubmed PY - 2018/12/12/medline SP - 1465 EP - 1465 JF - Scientific reports JO - Sci Rep VL - 7 IS - 1 N2 - Utility of syndromic case management (SCM) in women visiting obstetrics & gynecology department needs to be evaluated as it is subjective and imperfect. Consequently, antibiotic resistance has accelerated along with increased risk of infection to the partners. To understand the effectiveness and/or inadequacies of SCM, 11000 women were recruited and examined by clinicians for infection by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Bacterial vaginosis (BV) and others. Amongst these patients, 1797 (16.3%) reported vaginal discharge (VD). Other symptoms included: vaginitis (97%), cervicitis (75%), genital ulcers (60%), abnormal vaginal discharge (55%) and lower abdominal pain (48%). The patients were treated for single or co-infections using pre-packed National Aids Control Program III STI/RTI Kits. However, based on PCR diagnostics, 1453/1797 (81%) subjects were uninfected for NG/TV/CT. Amongst 344 (19%) infected patients, 257 (75%) carried infection with single pathogen (TV/NG/CT) while 87/344 (25%) were co-infected with multiple pathogens. Prevalence of TV, NG & CT was 4%, 7% and 8% respectively. Co-infection with CT + NG was highest, 51% (44/87), whereas, co-infection with CT + TV was 21% and NG + TV was 18% while co-infection with all three pathogens was 1.3%. We conclude that SCM is imprecise and successful intervention requires accurate and confirmatory diagnostic approach. SN - 2045-2322 UR - https://www.unboundmedicine.com/medline/citation/28469158/Evaluating_the_utility_of_syndromic_case_management_for_three_sexually_transmitted_infections_in_women_visiting_hospitals_in_Delhi_India_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓10 ↑44]

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