Assessment of the syndrome case management used by midwifery in Dakar in diagnosing symptomatic bacterial lower reproductive tract infections

Abstract

Introduction : Genital tract infection (GTI) was a major public health concern according to the World Health Organization (WHO) which had promoted the syndrome case management in low-resource settings. In Senegal, most of the data available on female GTI were retrospective or fragmented. This situation prompted us to conduct a prospective study comparing the diagnosis of midwives in symptomatic GTI in gynecological period with laboratory results, then with the conclusions of the syndrome case management.

Methodology : It was a cross-sectional, multi-site study carried out in six maternities in Dakar from July 2015 to November 2015. It concerned women aged 15 to 49, symptomatic and consenting received at these sites.

Results : For the majority of germs of the germs sought, the agreement rates showed a very weak agreement even a disagreement between the presumed diagnosis of the midwife, on the one hand, and, on the other hand, the laboratory results and the conclusions of the syndrome case management.

Conclusion : Thus, the hypothesis an empirical approach used by midwives could explain these discrepancies. However, the intrinsic lack of performance of the syndrome case management and its algorithms should lead WHO and its partners to propose alternatives to countries with limited resources.