Adding Strategies

The syndromic approach to STD management is not the complete solution to STD control. It works well for urethral discharge in men, genital ulcer disease in both men and women, and pelvic inflammatory disease, but is less than optimal for managing vaginal discharge, even with the addition of a risk assessment. Moreover, syndromic management was never designed as a tool for identifying infection in asymptomatic people. Greater support is required for additional approaches, including partner referral and treatment, services targeting high-risk populations, and comprehensive syphilis screening of ante-natal women. Rapid, inexpensive, simple diagnostic tests for gonococcal and chlamydial infection are urgently needed to improve the management of STDs in women.