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Randomized Controlled Trial
. 2016 Mar;92(2):135-41.
doi: 10.1136/sextrans-2015-052107. Epub 2015 Oct 1.

Three methods of delivering clinic-based training on syndromic management of sexually transmitted diseases in South Africa: a pilot study

Marcia R Weaver  1 , Erushka Pillay  2 , Suzanne L Jed  1 , Julia de Kadt  2 , Sean Galagan  1 , Jennifer Gilvydis  1 , Eva Marumo  3 , Shreshth Mawandia  4 , Evasen Naidoo  2 , Tamara Owens  5 , Vickery Prongay  1 , Gabrielle O'Malley  1
Affiliations
Randomized Controlled Trial

Three methods of delivering clinic-based training on syndromic management of sexually transmitted diseases in South Africa: a pilot study

Marcia R Weaver et al. Sex Transm Infect. 2016 Mar.

Abstract

Introduction: The South African National Department of Health sought to improve syndromic management of sexually transmitted infections (STIs). Continuing medical education on STIs was delivered at primary healthcare (PHC) clinics using one of three training methods: (1) lecture, (2) computer and (3) paper-based. Clinics with training were compared with control clinics.

Methods: Ten PHC clinics were randomly assigned to control and 10 to each training method arm. Clinicians participated in on-site training on six modules; two per week for three weeks. Each clinic was visited by three or four unannounced standardised patient (SP) actors pre-training and post-training. Male SPs reported symptoms of male urethritis syndrome and female SPs reported symptoms of vaginal discharge syndrome. Quality of healthcare was measured by whether or not clinicians completed five tasks: HIV test, genital exam, correct medications, condoms and partner notification.

Results: An average of 31% of clinicians from each PHC attended each module. Quality of STI care was low. Pre-training (n=128) clinicians completed an average of 1.63 tasks. Post-training (n=114) they completed 1.73. There was no change in the number of STI tasks completed in the control arm and an 11% increase overall in the training arms relative to the control (ratio of relative risk (RRR)=1.11, 95% CI 0.67 to 1.84). Across training arms, there was a 26% increase (RRR=1.26, 95% CI 0.77 to 2.06) associated with lecture, 17% increase (RRR=1.17, 95% CI 0.59 to 2.28) with paper-based and 13% decrease (RRR=0.87, 95% CI 0.40 to 1.90) with computer arm relative to the control.

Conclusions: Future interventions should address increasing training attendance and computer-based training effectiveness.

Trial registration number: AEARCTR-0000668.

Keywords: AFRICA; EDUCATION; HIV TESTING; SYNDROMIC MANAGEMENT.

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Figures

Figure 1
Figure 1
Participant flow diagram. Flow of clinics and training participants. HWC, health care worker; PHC, primary healthcare; SP, standardised patient.
See this image and copyright information in PMC

References

    1. Boonstra E, Lindbaek M, Koulman E, et al. Syndromic management of sexually transmitted diseases in Botswana's primary healthcare: quality of care aspects. Trop Med Int Health 2003;8:604–14. 10.1046/j.1365-3156.2003.01076.x - DOI - PubMed
    1. Voeten HACM, Otido JM, O'Hara HB, et al. Quality of sexually transmitted disease management in Nairobi, Kenya: a comparison among different types of health care facilities. Sex Transm Infect 2001;28:633–42. 10.1097/00007435-200111000-00005 - DOI - PubMed
    1. Otieno FO, Ndivo R, Oswago S, et al. Evaluation of syndromic management of sexually transmitted infections within the Kisumu Incidence Cohort Study. Int J STD AIDS 2014;25:851–9. 10.1177/0956462414523260 - DOI - PMC - PubMed
    1. Mbofana FS, Brito FJ, Saifodine A, et al. Syndromic management of Sexually Transmitted diseases at primary care level, Mozambique. Sex Transm Infect 2002;78:E2 10.1136/sti.78.1.e2 - DOI - PMC - PubMed
    1. Iipinge SN, Pretorius L. The delivery and quality of sexually transmitted infections treatment by private general practitioners in Windhoek Namibia. Glob J Health Sci 2012;4:156–71. 10.5539/gjhs.v4n5p156 - DOI - PMC - PubMed

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