Since 1990, the Nakuru Municipal Council (Kenya) has implemented a multifaceted program to reduce the incidence of reproductive tract infections (RTIs), especially those that are sexually transmitted, including HIV/AIDS. Staff in the Council’s five health clinics use syndromic management guidelines, based on clients’ reported symptoms and clinical signs, to identify clients with RTIs. In 1998, the Population Council conducted a study to assess the accuracy of syndromic management and determine the best ways to integrate RTI management into existing antenatal (ANC) and family planning (FP) services. After an assessment of existing RTI services, 18 nurses from the five municipal clinics attended a three-day refresher course in syndromic management. As noted in this brief, more than half of the FP and ANC clients in Nakura had one or more RTIs, and roughly one-third of these infections were sexually transmitted. Using syndromic management algorithms based on reported symptoms, providers correctly classified only 5–16 percent of women who later tested positive with laboratory results. Given the limitations of syndromic management, programs need to stress prevention of sexually transmitted infections.
"Kenya: Identifying RTIs remain problematic: Prevention is essential," FRONTIERS OR Summary. Washington, DC: Population Council, 2000.
Frontiers in Reproductive Health