小城镇诊所性病病征处理的应用

Application of syndromic approach for STIs management in rural clinics of Hainan and Guangxi provinces.

目的报告在海南省和广西壮族自治区三个农村城镇的公立和私立诊所,开展性病病征处理和性病预防培训后性病病征处理的应用情况.方法在开展培训的同时,通过诊所填写的门诊记录收集病征处理和性病预防服务的情况.结果1999年收集门诊记录598份(男性306,女性292),2000年收集461份(男性188,女性273).男性尿道分泌物病征占男性就诊者的60%～70%,但其中治疗处方符合标准的仅略高于20%;'阴道分泌物病征'约占女性就诊者的70%～80%,'生殖器溃疡病征'约占全部就诊者10%左右,这两种病征的治疗几乎都不符合标准.在诊所中得到性病预防服务的就诊者比例(WHO预防指标7),两年分别为44%和47%,诊所报告为其提供安全套的就诊者比例分别为50%和61%.结论参与项目的诊所性病病征处理应用情况距离国家标准还相差很大;但是通过培训和项目支持,这些诊所能够参与对就诊者的预防服务.

Objective To report the application of syndromic approach for STIs management in private and public clinics in three rural towns in Hainan and Guangxi provinces. Methods Structured consultation forms filled by practitioners were collected while the training program for these clinics was conducted in a period of two years. Results 598（men 306,women 292） and 461 （men 188, women 273） forms were collected, respectively, in 1999 and 2000. About 60 % ～ 70 % of male clients were diagnosed as urethral discharge syndrome. Only above 20 % of urethral discharge patients obtained treatment recommended by China Ministry of Health. Vaginal discharge syndrome took account for 70 % ～ 80 % of female clients, and genital ulcer for about 10 % of the clients. However, hardly any patient with above two syndromes received recommended treatment. There were 44% and 47% of clients,respectively,received prevention service in these clinics measured as WHO Prevention Indicator-7, and proportion of clients who obtained condoms at the clinics were about 50 % in 1999, and 61% in 2000. Conclusions Using syndromic approach is far less satisfactory in these rural clinics even after the training. However, more clients can obtain condom and prevention service from these clinics in case that the training and other support can be provided.