Changing patterns in sexually transmitted disease syndromes in Kenya after the introduction of a syndromic management program.

Objective: The objective of this study was to evaluate patterns in sexually transmitted disease (STD) syndromes after the introduction of an STD syndromic management program.

Study: We used the HIV sentinel surveillance in patients with STDs (1990-2001) to compute the proportions of STD syndromes (as a proportion of all patients with STDs) before and after the introduction of the syndromic management program.

Results: A decline in the proportion of genital ulcer disease (GUD), urethral discharge (UD), and vaginal discharge (VD) was observed from the baseline (1990-1994) to the year 2000 (P <0.0001). GUD declined from 27.6% at baseline to 11.0% in 2000; UD from 31.8% at baseline to 22.2% in 2000; and VD from 36.7% at baseline to 20.1% in 2000. Similar declines for these syndromes were also observed in sex and age groups. The proportions of GUD, UD, and UV increased again in 2001.

Conclusions: These changing patterns of STD syndromes were coincident with the introduction of the STD syndromic management program in 1995 and the termination of free STD medication in 2001.