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Advantages and Limitations of Syndromic
Management
 Advantages
of syndromic management:
- Immediate treatment:
Clients receive diagnosis and treatment within a single visit.
- Effectiveness: Clients
are treated for a potential mixed infection. The use of flowcharts with
appropriate treatment recommendations reduces the chance of ineffective
treatment. This approach helps to prevent incorrect diagnoses in settings
where clinical diagnosis is common.
- Ease of use: It
is easy to teach and learn, so all levels of health care providers and
facilities can use it. It requires good training, but not specialized
knowledge about RTIs.
- Low costs: There
are cost savings since expensive lab tests are not used.
Limitations and concerns:
- Limitations in diagnosing
vaginal discharge: Vaginal discharge poses a particular challenge
since the syndrome might not be related to an STI. Because of the potential
for negative reactions from clients and partners when the infection
may not even be caused by an STI, it is important to consider each case
on an individual basis. Women who do not have STIs but who have non-sexually
transmitted RTIs that cause vaginal discharge may be told they should
have their partners come for treatment; this can lead to relationship
problems, including violence.
- Potential for overtreatment:
Clients are treated for multiple infections, although some will
have no infection or only one. This is costly in terms of unnecessary
drug use, waste of drugs that could be used to treat other clients,
and the potential for microorganisms to develop resistance to antimicrobial
drugs.
- Ineffectiveness against
asymptomatic infections: This approach cannot be used with clients
who are infected but show no signs and symptoms.
- Need for data: Algorithms,
risk assessment tools, and treatment protocols should be based on information
that is difficult to collect in many settings, including: disease surveillance
data, studies of risk factors, an.d microbial resistance tracking in
the geographic location where the syndromic approach is being used.
© 2007 EngenderHealth
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