The Use of Epidemiologic Mass Treatment and Syndrome Management for Sexually Transmitted Disease Control

Background: Epidemiologic mass treatment and syndrome management are two sexually transmitted disease (STD) control strategies that are receiving increased attention internationally. The former is a population-based intervention, whereas the latter attempts to improve the quality and efficiency of clinic-based STD case management.

Methods: The published literature on these subjects was reviewed.

Results: Epidemiologic mass treatment refers to treatment of whole communities (mass treatment) or high-risk subgroups within communities (targeted presumptive treatment) based on high STD prevalence rates. Syndrome management overcomes many obstacles to provision of quality STD case management by basing treatment decisions on recognition of easily identifiable syndromes. Experience with application of these strategies is summarized, and their possible use as STD control measures in communities with similar conditions is discussed.

Conclusions: Epidemiologic mass treatment may be an effective approach to rapidly reduce STD transmission in high prevalence communities, especially when high-risk core groups are effectively reached. Once high prevalence rates are brought down, however, longer term strategies, including improved STD case management, are essential to maintain reduced rates.