Syndrome-wise diagnosis status of sexually transmitted infection/RTI in a subdivision level hospital of rural West Bengal.

Sir, Sexually transmitted diseases (STDs) are a particular group of communicable diseases that are transmitted by sexual contact and caused by a wide range of bacterial, viral, protozoal and fungal agents, and ecto-parasites. In the last few years, scientific facts regarding STDs have undergone a dramatic transformation[1] medical attention is now given not only to the specific diseases but also to the clinical syndromes associated with STDs.[2] True incidence of STDs will never be known because of both inadequate reporting and secrecy surrounding the disease. WHO estimates that at least 340 million new cases of STD other than HIV occurred in 1990-2000.[2,3] There is a dearth of information regarding the epidemiology of STDs in India for many reasons such as recent recognition of STDs as a major public health problem, stigma and discrimination associated with the STDs, lack of interdepartmental coordination for studies, poor attendance of STD patients at the public clinics and academic institutions, and availability of limited diagnostic facilities, among others. This in-depth clinical research offers an important insight into the burden and pattern of sexually transmitted infections (STIs) and on syndromic management of STIs. The traditional method of diagnosing STD is by laboratory tests. However, these are often not available or are expensive. Since 1990, WHO has recommended syndromic management of STDs in patents presenting with consistently recognized signs and symptoms of STD.[3,4] The syndromic approach is a scientifically derived approach and offers accessible and immediate treatment that is efficient and very much cost effective. Furthermore, this particular approach is incorporated into the general health service. This can also avoid unnecessary referral, leaving the specialized part of health service free of unwanted load. NACP-III has a mandate to strengthen all public health facilities at and above the subdivision level as designated STI/ Reproductive tract infection, (RTI), Sexually transmitted infection/Reproductive tract infection clinics.[4,5] Presently, National AIDS Control Organisation, (NACO) is supporting 916 designated STI/RTI clinics that are providing services based on enhanced syndromic case management. NACO has branded the STI/RTI services as “Suraksha clinic” and has also generated a communication strategy for generating demand for their services.[3]