Evaluation de la prise en charge diagnostique et thérapeutique des infections sexuellement transmissibles au CHU Gabriel Toure

But :Il s'agissait de rapporter des cas d'infection sexuellement transmissible (IST) en consultation et d'évaluer la prise en charge syndromique. Patients et méthodes : Nous avons effectué une étude prospective et descriptive chez les patients qui avaient consulté pour IST au service d'urologie du CHU Gabriel TOURE d'Avril 2013 à Mars 2014.Les cas VIH n'ont pas été inclus. L'approche syndromique a été utilisée. Résultats :Nous avons obtenu les résultats suivants : 460 cas d'IST (Dysurie, Cystite, Tuméfaction scrotale, Prostatite). Le sexe ratio était de 20,52 en faveur du sexe masculin. La tranche d'âge 23-32 ans était la plus touchée, les patients célibataires étaient les plus représentés. La majorité était bambara. Tous les cas avaient été diagnostiqués cliniquement. Les examens complémentaires étaient demandés pour avoir une confirmation du diagnostic. Sur le plan de la prise en charge syndromique, l'antibiothérapie probabiliste a été appliquée à chaque type IST. L'antibiothérapie, avait été réadaptée à l'antibiogramme avec une réponse thérapeutique efficace dans : 61,61% pour les prostatites, 98,60% pour l'urétrite, 100% tuméfaction scrotale, 90, 78%pour la cystite. Conclusion : La prise en charge des IST selon l'approche syndromique est une option dans les pays où le diagnostic de laboratoire n'est pas toujours disponible

Stakeholders' Perceptions of the Delivery and Quality of Sexually Transmitted Infection Treatment by Private Practitioners in Windhoek; Namibia

The primary objective of this study was to explore the perceptions of the community and other stakeholders regarding the delivery and quality of sexually transmitted infection (STI) treatment and care provided by private general practitioners (PGPs) in Windhoek; Namibia. The study provided a situational and contextual analysis employing qualitative methodologies using different methods of data collection. The methodology used included (1) a review of available country policy documents on STI management and surveillance; as well as the policy with regard to private primary care providers; (2) eight in-depth interviews conducted with key informants and (3) three focus-group discussions held with community members attending PGP practices in Windhoek. The perceptions of the care received from PGPs differed from one person to the next. It emerged that some participants had good experiences and some had negative experiences of the care given. The participants believed that going to a PGP for treatment is a matter of affordability that goes hand in hand with the expectations of receiving care; whilst maintaining confidentiality. The study established that there is no real difference between the care provided to patients with medical aid or those without medical aid. It is recommended that interactions between the public and private sector at various levels be initiated to ensure that curable STIs are appropriately managed and that national guidelines for STI management are adhered to. Health workers should also be sensitised about their approach towards patients. It is further recommended that awareness creation amongst PGPs with regard to the public health importance of STIs needs to be raised to encourage them to participate in the STI-control programme

Approche epidemioloque des maladies sexuellement transmissibles de la femme noire a Kinshasa

L'auteur fait une synthese de la prevalence de certaines M.S.T. a Kinshasa en se referant egalement aux taux constates ailleurs en Afrique et dans d'autres pays en developpement. Quelques M.S.T. ont fait l'objet de l'etude en raison soit de leur frequence soit de leurs effets nocifs sur la sante reproductive de la femme. Il s'agit de plusieurs pathologies dont les techniques de diagnostic ainsi que les modalites therapeutiques ont ete relatees

An investigation into the treatment seeking behavour of STD patients in Hwange District; an area with high STD prevalence

Hwange District is the largest district in Matabeleland North with a population of 142 000 (1992 census). In Hwange district the number of STD patients has remained persistently high in the past 5 years. This is despite the fact that Health Education campaigns have been intensified in the light of the HIV/AIDS epidemic; considering that STD's and HIV are transmitted in a similar way. Even children between the ages of 12 and 15 years have been treated for STDs. The main findings were: 1. half of STD patients sought treatment early; 2. the strong belief of both traditional healers and STD patients that cleansing is an essential part of the treatment for STDs; makes patients seek treatment from traditional healers even if symptoms have disappeared after treatment at a clinic; 3. Due to lack of communication between partners; re-infection by sexual partners occurred; 4. Negative attitudes of health workers which include confidentiality; privacy; and poor communication discourage patients from seeking treatment in health centres; 5. lack of Health Education to the patients who attend the health centres for treatment leaves them uninformed about their disease exposing them to re-infection; 6. antibiotics were said to be on sale over the counter in pharmacies at Victoria Falls and from Private doctors in Bulawayo

Efficacy of patient-delivered partner medication in the treatment of sexual partners in Uganda

Background: patient-based partner referral (PBPR); which is the main method for treating sexual partners of patients with sexually transmitted diseases (STDs); has limited effictiveness. Goal: The authors compared the efficacy of PBPR with patient-delivered partner medication (PDPM) among patients attending the Mulago STD clinic in Kampala; Uganda. Study design: A total of 383 patients (187 women; 196 men) with STDs were randomised to the PBPR or PDPM group. The proportion of sexual partners treated in either group was compared using the chosquare statistic by intention to treat for partners whose follow-up status was unknown. Results: The two groups has similar background characteristics. Of the 237 partners elicited; 176(74) were reported treated in the PDPM group. In the PBPR group; in which 234 partners were elicited; 79(34) were referred to the treatment clinic.This difference was statistically significant (risk ratio (RR); 2.44; 95CI; 1.95-3.07; P0.001). Furthermore; PDPM was more effective than PBPR for women and for casual partners for whom PBPR is considered difficult. For women; 86 of 103 partners in the PDPM group ; compared with only three of 45 partners (7) who were referred in the PBPR group (RR; 1.43; 95 CI; 1.40-2.65; p0.01). Conclusion : Patient-delivered partner medication is more effective than patient-based partner referral in the treatment of sexual partners