Inadequate treatment for sexually transmitted diseases in the South African private health sector

Correct management of sexually transmitted diseases (STDs) is important for their control, and to reduce HIV transmission. Guidelines on syndromic management of STDs were introduced by the provincial Department of Health in KwaZulu/Natal (KZN) in South Africa in 1995. The drug treatment provided for STDs by the 11 private general practitioners in one rural district was assessed and compared with provincial guidelines. Information was gathered through semi-structured interviews which asked the 11 doctors, who all dispense prescribed drugs as part of the consultation fee, how they would treat 3 hypothetical cases of STD syndromes. In all 33 prescriptions, the treatment did not correspond exactly with provincial recommendations and only 3 (9%) were adequate. All other prescriptions were inadequate because dose or duration was incorrect in 6 (18%), or because incorrect drugs were prescribed in 24 (73%) of cases. Eight of the 11 doctors did not provide adequate treatment for any of their cases. A continuing medical education programme for the doctors and their staff was devised to improve the STD treatment in the private sector in this South African district. The correct management of sexually transmitted diseases (STD) can help to control and reduce the spread of HIV infection. To that end, guidelines upon the syndromic management of STDs were introduced by the provincial Department of Health in KwaZulu/Natal (KZN) in South Africa in 1995. Drug treatment provided for STDs by 11 private general practitioners in 1 rural district was investigated and compared with provincial guidelines. Study data were collected through semi-structured interviews in which the doctors were asked how they would treat 3 hypothetical cases of STD. In all of the 33 prescriptions written by the physicians, the treatment failed to correspond exactly with provincial recommendations and only 3 were adequate. The other prescriptions were inadequate because either the dose or regimen duration was incorrect in 6 cases, and because the wrong drugs were prescribed in 24 cases. 8 of the physicians did not provide adequate treatment for any of their cases. A continuing medical education program for the doctors and their staff was subsequently created to improve the private sector treatment of STDs in KZN