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Predictors of Adherence to Syndromic Management Guidelines for Community-Based Management of Sexually Transmitted Infections: An Original Cross-Sectional Study

Year: 2026

Type: article

Abstract: Background: Syndromic management remains an important approach for the diagnosis and treatment of symptomatic Sexually Transmitted Infections (STIs), particularly in settings where laboratory-based diagnosis is unavailable, inaccessible, or unable to provide same-day results. Correct implementation of syndromic management depends not only on the availability of guidelines but also on healthcare-provider knowledge, training, clinical experience, availability of medicines, diagnostic resources, workload and institutional support. Inappropriate adherence may result in missed infections, unnecessary antimicrobial exposure, persistent symptoms, transmission to sexual partners and increasing antimicrobial resistance. Objective: To determine the level of adherence to syndromic management guidelines and identify provider-, patient- and facility-related predictors of adherence among healthcare providers managing patients with suspected STIs in community healthcare settings. Methods: A cross-sectional study design was proposed among healthcare providers involved in the management of patients presenting with STI-related symptoms. Data were collected using a structured provider questionnaire and a standardized clinical case-record assessment tool. Adherence was assessed against predefined syndromic-management criteria based on current WHO recommendations. The primary outcome was overall adherence to recommended history taking, examination, syndrome classification, treatment, counselling, partner management, testing and follow-up. Multivariable logistic regression was proposed to identify independent predictors of adherence. The numerical results presented below are illustrative data intended to demonstrate the structure and statistical presentation of the proposed original study and must be replaced with actual study data before submission. Illustrative Results: Among 240 assessed provider encounters, complete adherence to the syndromic-management algorithm was observed in 156 (65.0%). Provider training within the previous 24 months, availability of current guidelines, adequate availability of recommended medicines, lower workload and greater knowledge scores were positively associated with adherence. In multivariable analysis, recent guideline training, availability of guidelines at the point of care and higher knowledge scores remained independent predictors of adherence. Conclusion: Adherence to syndromic-management recommendations appears to be influenced by multiple interacting provider and health-system factors. Regular competency-based training, point-of-care access to updated guidelines, adequate medicine availability, supportive supervision and periodic clinical audits may improve adherence and strengthen the quality of STI case management.

Source: International Journal of Clinical and Medical Research

DOI: 10.66590/ijcmr2026030106