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The effectiveness of different strategies of case detection and management of sexually transmitted diseases in Mwanza, Tanzania


The project will be grafted on to the existing STD intervention project in Mwanza. The intervention consists of training of health care workers in STD case management and health education concerning Stds, improved supervision and the provision of adequate drugs and condoms. The project presented here will provide a detailed analysis of the operational characteristics of current STD case management, and will assess the effectiveness of the intervention in terms of improving the cure rate of Stds, occurring in the community. This will be done by considering the different steps patients with Stds take before they can be considered cured, i.e.: awareness of symptoms, contact with health services, infection suspected, infection confirmed, treatment prescribed, treatment obtained, treatment taken, treatment effective. The proportion of patients going from one step to the next will be quantified, using different methodologies, including community based surveys (proportion of asymptomatic patients, proportion of patients who contact the health services), facility based studies (proportion of asymptomatic STD patients among pregnant women, sensitivity of diagnostic procedures, performance of staff), follow-up of patients (compliance with treatment).
The potential effectiveness of contact tracing in detecting additional cases of asymptomatic STD, will be assessed, by examination of contacts of STD patients who attend the clinics. Baseline data will be collected on the prevalence of Stds in prostitutes, the sensitivity of clinical algorithms in case detection and healthseeking behaviour. These data will be used for designing appropriate interventions in core groups.


Instituut voor Tropische Geneeskunde Prins Leopold
2000 Antwerpen

Participants (2)

African Medical and Research Foundation

Dar Es-salaam
London School of Hygiene and TropicalMedicine
United Kingdom
Keppel Street
WC1E 7HT London