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Document 2593
DOCN M94A2593
TI Survey of STD management in mission hospitals in Zambia.
DT 9412
AU Plourde PJ; Sichinga K; Banda M; Churches Medical Association of Zambia.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):269 (abstract no. PB0505). Unique
Identifier : AIDSLINE ICA10/94369982
AB OBJECTIVE: To determine factors affecting the management of sexually
transmitted diseases (STD) in mission hospitals throughout Zambia.
METHODS: A pretested questionnaire was distributed to all 86 mission
health institutions in Zambia (32 hospitals and 54 rural health centres
[RHC]). Data was collected pertaining to STD clinical services,
laboratory facilities, drug supplies, and treatment practices. RESULTS:
Forty-three institutions responded to the questionnaire. Most reported
that STD patients were managed within general medical clinics (41/43) as
opposed to STD clinics (7/43). Few reported managing STD in prenatal
(8/43) or family planning (2/43) clinics. The number of STD patients
seen per month was 65.5 +/- 66.6 at hospitals and 20.1 +/- 26.3 at RHC.
More STD patients presented to fee-paying institutions vs non-fee-paying
(47.5 +/- 58.0 vs 16.0 +/- 14.6; P = 0.05). Laboratory facilities were
available at 32 institutions and mostly provided gram stain, wet mount
microscopy, syphilis serology, and HIV antibody testing (HIV-SPOT).
Confirmatory testing of HIV positive results was performed in 60% of
laboratories. STD drug shortages were reported by 80%. The only
consistently available STD drugs were penicillin, cotrimoxazole,
ampicillin, tetracycline, metronidazole, and erythromycin. The
percentage of institutions providing correct treatments were 76%
(gonorrhoea), 65% (chlamydia), 12% (chancroid), 100% (primary syphilis),
64% (latent syphilis), and 13% (PID). DISCUSSION AND CONCLUSIONS:
Mission health institutions, highly regarded as providing the best
health care in many developing countries, are struggling to provide
adequate management of STD in Zambia largely due to major material
constraints. Effective STD control is necessary to reduce the
transmission of HIV. To this end, there is an urgent need for STD
diagnostics and medications, along with improved training of health care
workers in STD management.
DE AIDS Serodiagnosis Cross-Sectional Studies *Developing Countries
Health Services Needs and Demand Hospitals, Religious Human Incidence
*Quality Assurance, Health Care Rural Health Sexually Transmitted
Diseases, Bacterial/DIAGNOSIS/*DRUG THERAPY/ EPIDEMIOLOGY Syphilis
Serodiagnosis Zambia/EPIDEMIOLOGY MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).