Management of sexually transmitted infections (STI)-associated syndromes by part-time general practitioners (GP) in Puttalam district

Introduction: Puttalam district shows higher rate of HIV. Considering the interaction between HIV and STI, management of STI-associated syndromes by GPs was studied. The objective of the study was to describe the management of STI-associated syndromes by GPs in Puttalam district.

 

Method: A descriptive cross-sectional study was done in Puttalam district from 1st February to 30^th April 2016 among 114 randomly selected part-time GPs using a self-administered questionnaire. Management of five STI syndromes was compared with national guidelines.

 

Results: Vaginal discharge and lower abdominal pain syndromes were encountered by majority (97%) of GPs. However, vaginal discharge was considered as the syndrome with the highest possibility of an STI by majority (93%) of GPs. Urine full report (94.9%) and VDRL (77.5%) were the commonest investigations ordered by GPs. Only 4.3% of patients with urethral discharge, 4.3% of patients with vaginal discharge, 15 % of patients with genital ulcers, 10.5% of patients with scrotal swelling and 1.7% of patients with genital warts were managed according to the national guidelines. Notably none of the patients with lower abdominal pain syndromes were managed according to the guideline. Management of partners of patients with STI syndromes were done by 50.9% of GPs. Majority of GPs (87%) educated patients on STI prevention. Most of the referrals were to the local STI clinic (74.6%) and most of these referrals were patients with genital warts (89.5%).

 

Conclusions: Large number of GPs is managing patients with STI syndromes. However, standard management of STI syndromes is done by only small number of GPs. Therefore, more educational and training programs on STI management for GPs are recommended.