Master of Public Health - MPH / The overall aim of this study was to evaluate quality of STI services in Umjindi local municipality. A concrete objective was to investigate the health system issues that may have a negative impact in the provision of quality STI service in the local municipality. These include accessibility of the STI services to the community, training of health workers in syndromic management, availability of necessary equipment and supplies for STI management, turn-around time for blood results and infrastructure of the facilities. / South Africa

Background: The burden of Sexually transmitted infections (STIs) is high globally. The World Health Organisation (WHO) recommends syndromic management of these STIs, based on presentation with signs and symptoms, in resource-limited countries. Due to this syndromic approach, there is little current data on STI prevalence, including asymptomatic STIs, in high risk populations. Methods: We reviewed secondary data collected as part of the screening procedures of 6 clinical trials between 2012 and 2017 in Cape Town, South Africa. These trials recruited populations of different sexual orientation and gender, mostly key populations at risk of HIV and STI acquisition. Routine screening for STI symptoms and testing for Chlamydia, Gonorrhoea, Trichomonas, Syphilis and HIV was performed for all of the studies at screening/enrollment. Results: A total of 639 participants were screened; 411 (64.3%) self-identifying as female, 198 (31%) males, 29 (4.5%) transgender women and 01 (0.2%) transvestite. Median age was 20 years (IQR: 18-24), with the 15-24-year age category contributing 77% to the cohort. Laboratory testing diagnosed 239 (37.4%) people with STI infections in this cohort; only 28 (11.7%) people were symptomatic. 119 (88.8%) of Chlamydial, 64 (82.1%) of Gonorrhoeal, 23 (92%) of Trichomonal and 31(79.5%) of Syphilis infections elicited no signs and/or symptoms. Conclusion: A vast majority of STIs in this high-risk population were asymptomatic. Laboratory testing of causal organism was more reliable in diagnosing STIs than the use of signs and/or symptoms as recommended by WHO.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2014-11-19T12:09:09Z No. of bitstreams: 2 Dissertação - Roberta Ribeiro Rios - 2012.pdf: 1382110 bytes, checksum: bf39296c44d43bcbbb2ab974af3fb6b4 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2014-11-20T14:20:46Z (GMT) No. of bitstreams: 2 Dissertação - Roberta Ribeiro Rios - 2012.pdf: 1382110 bytes, checksum: bf39296c44d43bcbbb2ab974af3fb6b4 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-11-20T14:20:46Z (GMT). No. of bitstreams: 2 Dissertação - Roberta Ribeiro Rios - 2012.pdf: 1382110 bytes, checksum: bf39296c44d43bcbbb2ab974af3fb6b4 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2012-09-08 / Syndromic management approach to sexually transmitted diseases consists of classifying the disease within predetermined syndromes, using flowcharts which are based on signs and symptoms establishing treatment immediately without waiting serological laboratory results for confirmation, providing at the first appointment the diagnosis, treatment and appropriate counseling, interrupting the transmission chain and avoiding the complications of sexually transmitted diseases, thus allowing immediate reversal of symptoms. But its success requires constant evaluation of the protocols, and training of professionals. OBJECTIVE: to assess the impact of in-service education on knowledge of nurses from Family Health Strategy regarding the use of the syndromic approach to sexually transmitted diseases before and after a training course. METHOD: This research was performed through the interventional study approach. The samples consisted of Brazilian Primary Care and Family Health Strategy Nurses. A survey to evaluate the knowledge about the syndromic management approach was applied before and after the education. RESULTS: 71 nurses participated in this study, and there was a significant improvement in knowledge concerning the syndromic approach (p <0.05); in relation to the identification of clinical signs, such as genital ulcers, urethral discharges and vaginal and pelvic pain, there was a significant improvement among the professionals after the training, with an increase in the percentage of 27%, 28%, 23% and 31% respectively. Regarding the prescription of drugs proposed for each syndrome, 40.84% of nurses reported performing the prescription for patients with genital ulcers, 49.30% prescribed to patients with urethral discharge, 84.5% to those with with vaginal discharge and cervicitis and only 22.53% with pelvic pain. CONCLUSION: The training of nurses has provided increased knowledge on the syndromic approach to sexually transmitted diseases. It is believed that these actions indirectly favor the reduction of the chain of transmission and spread of sexually transmitted diseases if they are being carried out with quality and effective intervention. It is therefore urgent that continuing education is effectively established at primary health care, ensuring an effective improvement of quality of care provided to patients with STDs. / A abordagem sindrômica das doenças sexualmente transmissíveis consiste em classificar a doença dentro de síndromes pré-estabelecidas, utilizando fluxogramas que se baseiam em sinais e sintomas, instituindo o tratamento imediato sem aguardar resultados de exames laboratoriais sorológicos para sua confirmação, provendo na primeira consulta o diagnóstico, o tratamento e o aconselhamento adequados, interrompendo a cadeia de transmissão e evitando as complicações advindas das doenças sexualmente transmissíveis permitindo dessa forma a regressão imediata dos sintomas, entretanto seu sucesso exige avaliação constante dos protocolos, e treinamento dos profissionais envolvidos. OBJETIVO: Avaliar o impacto das ações educativas no conhecimento de enfermeiros da Estratégia de Saúde da Família quanto à utilização da abordagem sindrômica das doenças sexualmente transmissíveis antes e após um curso de capacitação. MÉTODO: Estudo analítico e de intervenção com enfermeiros que atuam nas Unidades de Atenção Básica de Saúde da Família. Um questionário de avaliação do conhecimento sobre a abordagem sindrômica foi aplicado antes e após a educação permanente. RESULTADOS: Participaram desse estudo 71 enfermeiros, verificou-se uma melhora significativa no domínio dos conteúdos referentes à abordagem sindrômica (p<0,05 e na identificação dos sinais clínicos de úlceras genitais, corrimentos uretral e vaginal e dor pélvicacom acréscimos percentuais de 27%, 28%, 23% e 31%, respectivamente. Em relação à prescrição dos medicamentos propostos para cada síndrome 40,84% relataram realizar a prescrição para pacientes com úlceras genitais; 49,30% com corrimento uretral; 84,5% com corrimento vaginal e cervicite e apenas 22,53% com dor pélvica. CONCLUSÃO: A capacitação dos enfermeiros proporcionou uma melhora significativa do conhecimento em abordagem sindrômica de doenças sexualmente transmissíveis. Acredita- se essas ações sendo exercidas com qualidade e de forma resolutiva favorecem de maneira indireta a redução da cadeia de transmissão e a propagação de doenças sexualmente transmissíveis. Assim, torna-se relevante que a educação permanente seja efetivamente instituída na atençãol primária de saúde, garantindo uma melhora efetiva da qualidade da assistência prestada ao portador de doença sexualmente transmissível.

The overall aim of this study was to evaluate quality of STI services in Umjindi local municipality. A concrete objective was to investigate the health system issues that may have a negative impact in the provision of quality STI service in the local municipality. These include accessibility of the STI services to the community, training of health workers in syndromic management, availability of necessary equipment and supplies for STI management, turn-around time for blood results and infrastructure of the facilities.

The overall aim of this study was to evaluate quality of STI services in Umjindi local municipality. A concrete objective was to investigate the health system issues that may have a negative impact in the provision of quality STI service in the local municipality. These include accessibility of the STI services to the community, training of health workers in syndromic management, availability of necessary equipment and supplies for STI management, turn-around time for blood results and infrastructure of the facilities.

This study is about evaluating the effectiveness of training in syndromic management ofSTDs. The purpose of this study was to fmd out to what extent the STD training programme had been implemented. A stratified sample of twenty-two primary health care clinics in the Port Shepstone region was used. Twenty-two professional nurses rendering STD management in the clinics were observed. Data-gathering was done through a clinic inventory obtained by interviewing the sister-incharge, observation of professional nurses providing treatment to STD patients, interviews with professional nurses to assess their knowledge of the syndromic approach, and exit interviews with patients treated at the clinic. The fmdings suggest that certain areas in the STD training need to be emphasized, such as vaginal speculum and bi-manual examinations. It is recommended that certain negative aspects which hinder effective STD management, like staff shortages and lack of equipment be given attention. / Health Studies / M.A. (Health Studies)

This study is about evaluating the effectiveness of training in syndromic management ofSTDs. The purpose of this study was to fmd out to what extent the STD training programme had been implemented. A stratified sample of twenty-two primary health care clinics in the Port Shepstone region was used. Twenty-two professional nurses rendering STD management in the clinics were observed. Data-gathering was done through a clinic inventory obtained by interviewing the sister-incharge, observation of professional nurses providing treatment to STD patients, interviews with professional nurses to assess their knowledge of the syndromic approach, and exit interviews with patients treated at the clinic. The fmdings suggest that certain areas in the STD training need to be emphasized, such as vaginal speculum and bi-manual examinations. It is recommended that certain negative aspects which hinder effective STD management, like staff shortages and lack of equipment be given attention. / Health Studies / M.A. (Health Studies)