|
Project Topic
|
The high burden of sexually transmitted infections (STIs) and vaginal infections worldwide, but particularly in sub-Saharan Africa, has long been recognised by the World Health Organisation. In an effort to control such infections in resource-poor settings with no or limited laboratory infrastructure, the so-called ‘syndromic management guidelines’ were launched in 1978. These guidelines categorise infections by the symptoms they cause (such as ‘vaginal discharge syndrome’), and call for treatment of all pathogens that might cause that syndrome. The obvious advantage of this approach is that no laboratory testing is needed, but the obvious disadvantage is that all asymptomatic infections are missed. A considerable body of research has now shown that in fact the majority of STIs and vaginal infections in women are asymptomatic, and syndromic management is therefore not effective. The main aim of the WISH project is to improve case-finding and management of STIs and vaginal infections in Rwandan women by introducing point-of-care (POC) diagnostic testing. Rinda Ubuzima (RU) in Kigali, Rwanda, is a non-governmental organisation (NGO) specialised in HIV prevention and sexual and reproductive health (SRH) research in women. RU has operated a research clinic and laboratory in Kigali since 2004. In the WISH project, around 700 women at risk of STIs and vaginal infections will be seen in the RU research clinic. All of these women will be offered POC diagnostic testing for HIV, Trichomonas vaginalis (TV), and bacterial vaginosis (BV). Women who are considered to be at high risk using a risk scoring questionnaire (including all pregnant women) will also be offered POC testing for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and syphilis. Vaginal candidiasis, urinary tract infections (UTI), genital ulcers/inguinal bubos, and lower abdominal pain in women will be managed syndromically. The WISH study was designed to allow the researchers to evaluate the feasibility and cost effectiveness of introducing POC testing, and to assess the performance of the various POC tests. They will summarise their findings in a report and in scientific publications. In addition, the researchers will organise two workshops and interviews with stakeholders in Rwanda (stakeholders (clinicians, programme implementers and policymakers) to obtain their opinions about the about the potential improvement of urogenital infection care in Rwanda. They will summarise these discussions, as well as findings from a desk review of relevant published documents about this topic, in a report. More information about the project and its progress is available on the WISH website.
|
