Document 2593
 DOCN  M94A2593
 TI    Survey of STD management in mission hospitals in Zambia.
 DT    9412
 AU    Plourde PJ; Sichinga K; Banda M; Churches Medical Association of Zambia.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):269 (abstract no. PB0505). Unique
       Identifier : AIDSLINE ICA10/94369982
 AB    OBJECTIVE: To determine factors affecting the management of sexually
       transmitted diseases (STD) in mission hospitals throughout Zambia.
       METHODS: A pretested questionnaire was distributed to all 86 mission
       health institutions in Zambia (32 hospitals and 54 rural health centres
       [RHC]). Data was collected pertaining to STD clinical services,
       laboratory facilities, drug supplies, and treatment practices. RESULTS:
       Forty-three institutions responded to the questionnaire. Most reported
       that STD patients were managed within general medical clinics (41/43) as
       opposed to STD clinics (7/43). Few reported managing STD in prenatal
       (8/43) or family planning (2/43) clinics. The number of STD patients
       seen per month was 65.5 +/- 66.6 at hospitals and 20.1 +/- 26.3 at RHC.
       More STD patients presented to fee-paying institutions vs non-fee-paying
       (47.5 +/- 58.0 vs 16.0 +/- 14.6; P = 0.05). Laboratory facilities were
       available at 32 institutions and mostly provided gram stain, wet mount
       microscopy, syphilis serology, and HIV antibody testing (HIV-SPOT).
       Confirmatory testing of HIV positive results was performed in 60% of
       laboratories. STD drug shortages were reported by 80%. The only
       consistently available STD drugs were penicillin, cotrimoxazole,
       ampicillin, tetracycline, metronidazole, and erythromycin. The
       percentage of institutions providing correct treatments were 76%
       (gonorrhoea), 65% (chlamydia), 12% (chancroid), 100% (primary syphilis),
       64% (latent syphilis), and 13% (PID). DISCUSSION AND CONCLUSIONS:
       Mission health institutions, highly regarded as providing the best
       health care in many developing countries, are struggling to provide
       adequate management of STD in Zambia largely due to major material
       constraints. Effective STD control is necessary to reduce the
       transmission of HIV. To this end, there is an urgent need for STD
       diagnostics and medications, along with improved training of health care
       workers in STD management.
 DE    AIDS Serodiagnosis  Cross-Sectional Studies  *Developing Countries
       Health Services Needs and Demand  Hospitals, Religious  Human  Incidence
       *Quality Assurance, Health Care  Rural Health  Sexually Transmitted
       Diseases, Bacterial/DIAGNOSIS/*DRUG THERAPY/  EPIDEMIOLOGY  Syphilis
       Serodiagnosis  Zambia/EPIDEMIOLOGY  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).