Main STD/RTI syndromes and their causative agents occurring in Mwanza Region, with treatment regimens used for each syndrome in the STD intervention
| Syndrome | Common aetiologies in east Africa | Treatment regimen used in the STD intervention |
|---|---|---|
| NB: in pregnancy, doxycycline and ciprofloxacin are replaced by erythromycin (500 mg td for 7 days). | ||
| (1) Treatment given at first visit. | ||
| (2) Treatment given if no improvement after 7 days and reinfection unlikely. | ||
| (3) Treatment given if no improvement after further 7 days and re-infection unlikely. | ||
| bd = twice per day, td = three times per day, stat = single dose, im = intramuscular, TMP-SMX = trimethoprim-sulfamethoxazole. | ||
| Genital ulcer | • chancroid (Haemophilus ducreyi) | (1) TMP-SMX 320 mg/1600 mg bd for 2 days + benzathine penicillin 2.4 million units im stat |
| • syphilis (Treponema pallidum) | (2) TMP-SMX 320 mg/1600 mg bd alternate days × 3 | |
| • herpes (herpes simplex virus-2) | (3) Ciprofloxacin 250 mg bd for 3 days (no treatment for herpes) | |
| Urethral discharge in men | • gonorrhoea (Neisseria gonorrhoeae) | (1) TMP-SMX 400 mg/2000 mg bd for 2 days + doxycycline 100 mg bd for 7 days |
| • chlamydia infection (Chlamydia trachomatis) | (2) Metronidazole 2 g stat + doxycycline 100 mg bd for 7 days | |
| • trichomoniasis (Trichomonas vaginalis) | (3) Ciprofloxacin 500 mg stat | |
| Vaginal discharge | • trichomoniasis• bacterial vaginosis (anaerobic bacteria) | (A) If discharge does not appear like thrush: |
| • cervical infections (gonococcal and chlamydial) | (1) TMP-SMX 400 mg/2000 mg bd for 2 days + doxycycline 100 mg bd for 7 days + metronidazole 2 g stat | |
| • if appears like thrush: candidiasis (Candida albicans) | (2) Doxycycline 100 mg bd for 7 days | |
| (3) Ciprofloxacin 500 mg stat | ||
| (B) If discharge appears like thrush: | ||
| Nystatin pessaries one at night, for 7 days or: application of 1% gentian violet solution | ||
| Lower abdominal tenderness | if caused by pelvic inflammatory disease (PID): | (1) TMP-SMX 400 mg/2000 mg bd for 2 days + doxycycline 100 mg bd for 14 days + metronidazole 400 mg bd for 7 days |
| • gonorrhoea | (2) Ciprofloxacin 500 mg stat | |
| • chlamydia infection | ||
| • anaerobic bacteria | ||