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Behavioral Counseling

A more definite or etiological diagnosis may be possible in some settings with sophisticated laboratory facilities, but this is often problematic. Laboratory tests require resources, add to the cost of treatment, may require clients to make extra visits to the clinic and almost always result in delays in treatment.


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For these reasons, syndromic management guidelines are widely used for syndromes such as lower abdominal pain, urethral discharge and genital ulcer Table 8. WHO has developed simple flowcharts also called algorithms to guide health care providers in using the syndromic approach to manage seven syndromes.

A problem-based approach

Five of these algorithms for vaginal discharge, lower abdominal pain, genital ulcer, inguinal bubo and urethral discharge are included in this chapter, adapted where needed for application in reproductive health settings. The algorithms may change from country to country depending on the prevalence of disease, the cost of drugs, and microbial resistance patterns. Syndromic algorithm Rationale for use Syndromic algorithms for urethral discharge in men and genital ulcers in men and women are both effective and practical.

Gonorrhoea and chlamydia are among the important causes of urethral discharge. Syphilis and chancroid are among the important causes of genital ulcers.

Adolescents and Young Adults

Properly used, these algorithms permit health care workers to provide effective treatment for symptomatic patients. They are simple and can be used even in remote areas as long as the necessary medicines are available. Equally important, syndromic management of these problems prevents new infections by providing curative treatment without delay and breaking the chain of infection.


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The syndromic approach to lower abdominal pain in women is widely used, even in developed countries. Gonorrhoea and chlamydia are among the important causes of lower abdominal pain in women. It will also provide a helpful refresher for family physicians and practice nurses who wish to become more involved in sexual health, and for family planning doctors and nurses who are being increasingly called upon to manage STIs. An experienced teacher as well as practitioner, he is a Senior Lecturer in Genitourinary Medicine at the University of Edinburgh. Log in to your account.

Sexually transmitted infection - Wikipedia

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