Possible Symptoms or Signs

Lower abdominal pain with possible vaginal/cervical discharge -Yes-

1. Co-trimoxazole (O) 8 x 480 mg tablets once a day for 2 days.

2. Doxycycline (O) 100 mg every 12 hours (sun-up and sun down) for 14 days

3. Metronidazole (O) 400-500 mg. every 12 hours for the first 7 days.

Check for improvement at the end of 7 days. REFER if none.

NO

Vaginal discharge WITHOUT ANY LOWER ABDOMINAL PAIN-Yes-

1. Co-trimoxazole (O) 8 x 480 mg tablets once a day for 2 days.

2. Doxycycline (O) 100 mg every 12 hours (sun-up and sun down) for 7 days.

3. Metronidazole (O) 2.0 g in one dose.

Check for improvement at the end of treatment. REFER if none.

NO

Genital ulcers/erosions Genital Ulcer Disease, (GUD)

1. Benzathine penicillin 2.4 MU deep IM, half into each buttock:

2. Co-trimoxazole (O) 8 x 480 mg tablets in one dose.

3. Gentian Violet 0.5-1.0% to ulcers

Check for improvement after 7 days REFER if none.

NO

Bubo. Swollen tender lymph-glands (nodes) in the groin -Yes-

1. Doxycycline (O) 100 mg every 12 hours (sun-up and sun down) for 14 days

2. If PREGNANT or BREAST FEEDING, Erythromycin 500 mg every 6 hours for 14 days

Check for improvement, at least of tenderness after 7 days.

REFER if none.

NO

Candida infection. Swelling and itchy soreness of the labia, possibly with some thick discharge -Yes.

1. Gentian violet 0.5-1.0% painted on lower vaginal, labia and skin every other day x 3 if needed.

2. Clotrimazole pessary 500 mg. One inserted deep into the vagina at bed time.

Check for improvement, after 7 days REFER if none.

Genital Warts

Carefully apply either 10-25% Podophyllin or 80% Trichloracetic acid to the warts, and wash off in 6 hours, drying thoroughly. Treat every 2-3 days until warts are gone.

Non-itchy rashes on the body or non tender swollen lymph glands at several sites-Yes.

Treat for secondary syphilis with Benzathine penicillin 2.4 MU deep IM half into each buttock. If no improvement in 7 days REFER.