Chandra Sonkar

Vaginal discharge constitutes an important symptom in women attending outpatient clinics of RTI/STI, Medicine and Obs & Gyne. Some of these cases are due to sexually transmitted diseases like such as N. gonorrheae, C. trachomatis and T. vaginalis and can lead to adverse reproductive health and co-infection with HIV. The control of these infections can lead to substantial reduction in the transmission of HIV. Given the high cost of diagnosis, National Aids Control Organization advocates syndromic case management of patients with genitourinary complaints and treatment with drugs that target the most frequent etiological agents. However, it can lead to emergence of antibiotic resistant strains due to overtreatment. The utility of syndromic case management (SCM) is not as good in the treatment of vaginal discharge syndrome due to its limitations of distinction between cervicitis and vaginitis. The narrative of this book critically appraises the syndromic approach to trichomoniasis and other STIs, discusses the challenges that it faces, and offers suggestions to improve its performance.