Changing patterns in sexually transmitted disease syndromes in Kenya after the introduction of a syndromic management...

The objective of this study was to evaluate patterns in sexually transmitted disease (STD) syndromes after the introduction of an STD syndromic management program.

We used the HIV sentinel surveillance in patients with STDs (1990-2001) to compute the proportions of STD syndromes (as a proportion of all patients with STDs) before and after the introduction of the syndromic management program.

A decline in the proportion of genital ulcer disease (GUD), urethral discharge (UD), and vaginal discharge (VD) was observed from the baseline (1990-1994) to the year 2000 (P <0.0001). GUD declined from 27.6% at baseline to 11.0% in 2000; UD from 31.8% at baseline to 22.2% in 2000; and VD from 36.7% at baseline to 20.1% in 2000. Similar declines for these syndromes were also observed in sex and age groups. The proportions of GUD, UD, and UV increased again in 2001.

These changing patterns of STD syndromes were coincident with the introduction of the STD syndromic management program in 1995 and the termination of free STD medication in 2001.