Kantharaj K, Mertens T E, Smith G D, Mugrditchian D, Van Dam C J, Radhakrishnan K M
State AIDS Project Cell, Tamil Nadu.
Indian J Public Health. 1995 Jul-Sep;39(3):93-9.
A baseline evaluation of the quality of STD case management was conducted in five areas of Madras city in 1992, using HIV prevention indicators recommended by the World Health Organization. Eighty-four interviews and 108 observations of private and public clinic practitioners were conducted. Sixty-one percent of interviewed doctors reported making only specific "clinical" diagnoses and 17% reported making only the WHO recommended syndrome-based diagnoses while 22% reported making both types of diagnosis. The adequacy of treatment was compared against various standards, including the Indian National Guidelines for STD management. Almost half of the health care providers (HCP) reported using a treatment effective against the two main pathogens that may cause male urethritis, while 20% reported using a treatment that was not effective against either. For male ulcers only 12% of HCPs reported using treatment effective against both syphilis and chancroid. Seventy-nine percent of the HCP reported that they advised their patients to use condoms, but in 30% only of observed consultations, condoms were promoted for STD or HIV/AIDS prevention. As information concerning the relative prevalence of pathogens in different areas is unlikely to be available, there is an urgent need for the syndromic approach to STD treatment be adopted by health care providers.
1992年，采用世界卫生组织推荐的艾滋病预防指标，对马德拉斯市五个地区的性传播疾病病例管理质量进行了基线评估。对私立和公立诊所的从业者进行了84次访谈和108次观察。61%的受访医生报告仅做出特定的“临床”诊断，17%报告仅做出世界卫生组织推荐的基于综合征的诊断，而22%报告两种诊断都做。将治疗的充分性与各种标准进行了比较，包括印度国家性传播疾病管理指南。近一半的医疗服务提供者（HCP）报告使用了对可能导致男性尿道炎的两种主要病原体有效的治疗方法，而20%报告使用的治疗方法对任何一种病原体都无效。对于男性溃疡，只有12%的医疗服务提供者报告使用了对梅毒和软下疳都有效的治疗方法。79%的医疗服务提供者报告说他们建议患者使用避孕套，但在仅30%的观察到的咨询中，为预防性传播疾病或艾滋病毒/艾滋病推广了避孕套。由于不太可能获得不同地区病原体相对流行率的信息，医疗服务提供者迫切需要采用性传播疾病治疗的综合征方法。
