title: Assessing therapeutic management of vaginal and urethral symptoms in an anonymous HIV testing centre in Luanda, Angola.
abstract: BACKGROUND
  This study aimed to estimate the prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infections and to assess the therapeutic management of vaginal/urethral discharge and dysuria in patients with human immunodeficiency virus in Luanda, Angola, taking into account World Health Organization recommendations for sexually transmitted infection syndromic management.
  
  
  METHODS
  Socio-demographic and medical data were obtained from 436 individuals, and clinical examinations were performed in 104 women and 8 men. Vaginal/cervical and urethral specimens were collected from 112 individuals for observation of Trichomonas vaginalis, yeasts and bacterial vaginosis, while urine samples were obtained from 415 patients (221 symptomatic and 194 asymptomatic). Diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis was performed by polymerase chain reaction assay.
  
  
  RESULTS
  The prevalence of N. gonorrhoeae and C. trachomatis was 8.4% (35/415) and 7.9%, (33/415) respectively. Eight of the 35 N. gonorrhoeae positive cases were treated. All men and women (79) who presented a positive wet mount/Gram stain were etiologically treated according to microscopy results. In contrast, 53.3% of the female patients (16/30) and 33.3% (1/3) of the male patients who presented microscopy negative results were treated for urinary tract infection or by syndromic approach. Among non-examined patients, 15% of women (12/80) and 52.5% of men (21/40) were treated without an etiological result. Syndromic treatment was preferentially given to non-examined males (19/40-47.5%) over females (12/80-15%) (p<0.01).
  
  
  CONCLUSIONS
  The prevalence of N. gonorrehaea and C. trachomatis found in this study was high. WHO-recommended syndromic management of vaginal/urethral discharge is not being consistently and correctly applied.
authors.affiliation: Instituto de Higiene e Medicina Tropical Lisboa, Portugal. hanna.guimaraes@gmail.com.
authors.forename: Hanna
authors.initials: H
authors.lastname: Guimarães
authors.forename: Rita
authors.initials: R
authors.lastname: Castro
authors.forename: Luís
authors.initials: L
authors.lastname: Távora Tavira
authors.forename: Filomena
authors.initials: F
authors.lastname: da L Exposto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000810:Angola / Q000453:epidemiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D015995:Prevalence; D013812:Therapeutics; D014247:Trichomonas Vaginitis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D014526:Urethritis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult