SEXUALLY TRANSMITTED INFECTIONS (INCLUDING HIV INFECTION) CARE MANAGEMENT USING THE "MODIFIED SYNDROMIC APPROACH" IN MALAYSIA

Abstract

Four hundred and thirty five (435) cases of sexually transmitted i1ifections (STis) were notified from 20 (twenty) primary care clinics throughout Malaysia from June 1999 till September 2000 using the syndromic approach of ST[ management, adapted by the Ministry of Health based upon the criteria set by the World Health Organisation (WHO). Gonorrhoea was the most prevalent STI reported (30.34 %), followed by candidiasis (28.05%), syphilis (15.17%) and non-specific urethritis (NSU) -14.02%). As seen in most other parts of the world, the younger age groups (those between twenty and thirty nine years old) were found to be more commonly infected with STIs. Initial analysis shows that systematic data collection based on the syndromes and clear-case definitions ( algorithms for the syndromic approach) need to be developed and added further to the current manual that is being developed for the health and medical staff at the operational level. Exploration and expansion of behavioural surveillance research, management information systems of the syndromic approach, and development of new or additional strategies in the manual for the staff too, also need improvement. The Ministry of Health is also concerned about the quantity and quality of the available data based upon syndromic management of STI as compared to laboratory based criteria. Since this programme is very much client centered, the adoption of this approach generally might offer substantial improvements in the quality and effectiveness of STI care, either within the public or the private health care settings in Malaysia.