Quality of Sexually Transmitted Infections (STIs) Case Management Was Found Poor in Health Care Facilities of Adama Town, Eastern Ethiopia 2015; The Missed Opportunities to Control HIV Spread

Background: Sexually transmitted infections (STIs) cause devastating sexual and reproductive health complications if poorly treated. Moreover, people with STIs are at higher risk of acquiring or transmitting HIV infection. World health organization (WHO) recommends 90% of primary point-of-care sites provide comprehensive care for people with STIs by 2015. Thus, the objective of this study was to assess quality of STIs case management and identify its determinant factors

Methods: Health facility based survey was conducted from May 16 to 26, 2015 in Adama town which is popularly hot spot for commercial sex. First, a total of 66 STIs management service providing units were randomly selected. Thereafter, health care providers working in the units were surveyed employing contextualized WHO tool. The level to which health care providers correctly manage STIs was computed and associated factors with incorrect management were assessed employing Chi-square (X²) test.

Results: generally, 62 (94%) providers responded to the interview. About 45 (72.6%) providers treated a total of 211 STI cases in a month preceding the survey.  Out of 53 (85.5%) providers that responded they were using syndromic approach for STI case management, only 29 (54.7%) correctly mentioned treatment for urethral discharge syndrome. Receiving no training on national guidelines was found significantly associated with stating incorrect regimen (X²_corrected = 6.40; p = 0.01). For vaginal discharge syndrome, also, only 20 (37.7%) providers correctly mentioned the treatment. Receiving no training (X²_corrected = 14.00; p < 0.001), less than 5 days training (Fisher’s exact test p = 0.038) and being diploma level profession (X²_corrected = 7.85; p = 0.005) were found significantly associated with stating incorrect regimen. Concerning genital ulcer syndrome, only 2 (3.8%) providers mentioned the correct regimen.

Conclusions: quality of STI case management was found poor. Thus, Training of health care providers on national guidelines for at least five days is of paramount importance