Utility of syndromic approach in management of sexually transmitted infections:public health perspective

Sexually transmitted infections(STIs)are infections that are mainly transmitted from person-to-person through sexual contact.Untreated or inadequately treated STIs can have significant impact on the maternal and newborn health.An extensive search of all materials related to the topic was made using library sources including PubMed,Medline and World Health Organization website for a period of one month.Relevant documents,technical publication series,systematic reviews,research articles focusing on the practice of syndromic management in treatment of STIs published in the period 1995-2013 were included in the review.The identified articles were then re-grouped into different sections for better understanding.Keywords used in the search include syndromic management,sexually transmitted infections,women,reproductive age-group and pregnancy.There is an immense need for implementation of prevention and control of STIs because of the associated morbidity/mortality,association with HIV and adverse outcomes of pregnancy and burdening of the health system.Multiple socio-demographic determinants have been identified,which usually precipitates STIs.In addition,some of the barriers have been recognized which is hampering with the expected utilization of the health care services.To counter the high prevalence of reproductive tract infection/STI,especially in countries with limited resources,syndromic diagnostic approach has been adopted by countries for the standardized management of sexually transmitted disease cases.The aim of syndromic management is to identify a syndrome and treat it accordingly with combination therapy which will cover the main pathogens that cause it.Strategies have been suggested to overcome the limitations of the syndromic approach and bring the problem under control.To conclude,syndromic management is a rapid and cost-effective approach in reducing the transmission of STIs.

Facilitating the Implementation of Sexually Transmitted Infection Syndromic Management in China

Objerctive: To introduce the current status of implementing sexually transmitted infection (STIs)syndromic management in China. Methods: Data werecollected and analyzed from the literature. Possiblesolutions were suggested for the obstacles encountered inthe implementation process. Results: Validation of revised flowcharts for themanagement of three syndromes (urethritis, vaginaldischarge, and genital ulcers) has been conducted in China.The feasibility, effectiveness and acceptance of using asyndromic STI approach were investigated in a large studyin Hainan, Zhejiang and Hubei Provinces. Chief obstaclesto implementation included the following: lack of supportfrom government authorities; negative reaction by hospitals;lack of critical thinking and innovation; perceivedover-emphasis on treatment at the expense of prevention;and lack of coverage for several important pathogens withintreatment algorithms. Possible solutions may include policyadvocacy, adopting syndromic management into a Chinesecontext, ssemination and promotion, training of providers, encouraging use of syndromic approach, and conductingoperational rescarch. Conclusions: Syndromic STI management provides afeasible approach for the diagnosis and treatment of STIs inChina. Further efforts should be made for scaling up itsapplication in clinical settings.

Give Full Play the Role of Traditional Chinese Medicine to Prevent and Treat Severe Acute Respiratory Syndrome with Integrative Chinese and Western Medicine Approach

Member of Political Bureau of Central Committee of CPC, Vice Premier of State Council concurrently Minister of Health, General Command of National Protecting and Treating Severe Acute Respiratory Syndrome ( SARS) Headquarters Vice premier WU Yi cordially met the well-known TCM specialists, and held a symposium with them. Sixteen specialists including WANG Yong-yan, CHEN Ke-ji, LI Fu-ren, JIAO Shu-de, HE Pu-ren, LIU