Management of patients with sexually transmitted infections by general practitioners in the district of Gampaha

Abstract

INTRODUCTION: In Sri Lanka, care for sexually transmitted infections (STIs) is given by both public and private sectors. Though there is an organized system for provision of care in government STD clinics, system available for the same purpose in private sector has not been studied. OBJECTIVE: To describe the knowledge and practices related to the management of patients presenting with symptoms and signs of sexually transmitted infections (STD Syndromes) among general practitioners in the District of Gampaha. METHOD: A descriptive cross sectional study was carried out among 200 general practitioners. Data were collected by using a self-administered structured questionnaire in English language and analyzed using SPSS 16. RESULTS: Majority of the study population were male (76%) with MBBS qualifications (97%) and involved in part time general practice (92.5%). Significant number (21% ) of GPs have not heard the term syndromic management of STDs. Almost three quarter (74%) of GPs did not use any guideline for the management for STIs. Only a minority of GPs has prescribed the recommended antibiotic combination for patients presenting with urethral discharge (10%), vaginal discharge (16%), non vesicular genital ulcers (3.5%) and vesicular genital ulcers (35%). Majority (55.5%) of GPs have done condom promotion. Counselling on STI prevention was done only by about half (48%) of the GPs. CONCLUSIONS: Most GPs were not aware of the syndromic management of STDs. Diagnostic tests that have been carried out were not appropriate to the symptoms and recommended treatment was not prescribed for most of the syndromes. They were unfamiliar with the STI management guidelines.