Definition

The syndromic approach is an answer to many of the obstacles to efficient STD case management in developing countries. It is based on identifying a syndrome, a group of symptoms (what the patient feels or has noticed) and easily recognized signs (what the clinician finds on examination) associated with a number of well-defined etiologies (the specific organisms causing disease). Once a syndrome has been identified, treatment can be provided for the majority of the organisms responsible for that syndrome.

The syndromic approach allows health care workers to make a diagnosis without sophisticated laboratory tests. Several STD syndromes can be managed easily and rapidly using clinical flowcharts for diagnosis and treatment. A clinical flowchart (also known as an algorithm or a decision tree) depicts a path of diagnostic reasoning. It is a logical, step-by-step, standardized guide to medical decision making. The World Health Organization recommends national STD control programs incorporate diagnostic and therapeutic flowcharts into their STD management guidelines.¹⁰

The syndromic approach to STD case management provides health workers in low-resource settings with practical tools to improve the diagnostic and treatment process. Based upon what is known about the prevalence of specific STDs in a given health care setting (including drug resistant stains), case management protocols are developed using common symptoms of STDs (urethral discharge, genital ulcer, vaginal discharge, lower abdominal pain, scrotal swelling) as the starting point and the patient management decision as the end point. As with all good STD management approaches, syndromic STD management also directs health workers to educate clients about STD prevention practices and partner notification.