Risk factors associated with failure of syndromic treatment of sexually transmitted diseases among women seeking primary care in Addis Ababa.
OBJECTIVE
To determine risk factors associated with the failure of syndromic management of sexually transmitted diseases (STDs) among women seeking treatment in primary healthcare centre in Addis Ababa, Ethiopia.


METHODS
Women with symptomatic STDs seeking care in a health centre were prospectively enrolled. A total of 259 women were interviewed and underwent clinical examination; 106 were enrolled and received syndromic STD treatment and 91% returned for follow up. Logistic regression analysis was used to identify risk factors associated with treatment failure.


RESULTS
Of the 106 women enrolled and presenting with symptomatic STDs 67% were HIV seropositive. Syndromic STD treatment did not result in clinical improvement in 30% of the women. Having genital ulcer disease, genital ulcer disease with genital discharge, genital warts, bacterial vaginosis and plasma HIV-1 load >10,000 copies RNA/ml or being HIV seropositive were all significantly associated with treatment failure. In multivariate analysis, however, only genital ulcer disease was significantly associated with treatment failure.


CONCLUSIONS
In our setting, the association between HIV and genital ulcer disease caused by herpes may, therefore, be the reason for the failure of treatment.
Ethio-Netherlands AIDS Research Project (ENARP), Ethiopian Health and Nutrition Research Institute (EHNRI), PO Box 8297, Addis Ababa, Ethiopia. dawit@enarp.com
D
D
Wolday
Z
Z
G-Mariam
Z
Z
Mohammed
H
H
Meles
T
T
Messele
W
W
Seme
A
A
Geyid
S
S
Maayan
D000293:Adolescent; D000328:Adult; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005831:Genital Diseases, Female / Q000150:complications / Q000453:epidemiology; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000628:therapy*; D017211:Treatment Failure; D014456:Ulcer / Q000150:complications / Q000453:epidemiology