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Syndromic management of sexually transmitted diseases at primary care level, Mozambique
  1. F S Mbofana,
  2. F J Brito,
  3. A Saifodine,
  4. J L Cliff
  1. Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
  1. Correspondence to:
 Dr Julie Cliff, Faculdade de Medicina, Universidade Eduardo Mondlane, CP 257, Maputo, Mozambique; 


Objective: To assess STD management in primary healthcare facilities where STD clinics and syndromic management guidelines had been introduced.

Methods: In 26 health facilities in selected sites, we observed management of all STD patients presenting in the adult general or STD clinic. We assessed the referral system by analysing patient registers.

Results: 408 STD patients (65% in STD and 35% in general clinics) were observed. 70% were women. Women were examined less (26% against 75%, p<0.0001), had laboratory tests ordered more (74% against 45%, p=0.0002), were more often diagnosed syndromically (57% against 38%, p=0.008), and received less advice on condom use (19% against 87%, p<0.001) and contact treatment (47% against 81%, p=0.04). Examination, laboratory requests, diagnosis, and treatment were not significantly different in the STD and general clinic. Health education was better in the STD clinic (condom advice 47% against 8%, p <0.001). Only 41% of referred patients presented to the STD clinic.

Conclusions: The better performance of STD clinics in health education was offset by high referral losses. A proposed integration of STD treatment into general outpatient clinics and better implementation of syndromic management and health education should improve STD case management at primary level in Mozambique.

  • sexually transmitted diseases
  • case management
  • Mozambique

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