Case Definition

Consider Gonorrhea/Chlamydia

  • Purulent discharge5, 20, dyspareunia6, 20
  • Treat partners5, 6, 7, 8, 11

Consider Trichomonas Vaginitis

  • Profuse malodourous yellow/green, frothy, adherent discharge, vulvar pain, itching, new partner6
  • Treat partners5, 6, 7, 8, 11

Consider Bacterial Vaginosis

  • Mild vaginal discomfort/itching6
  • Thin white/grey, homogeneous vaginal discharge6, 8,

Consider Candida vaginitis

  • White, odourless “cottage-cheese” like discharge, severe external itching, correlation with menstrual cycle and antibiotic use, redness of labia3,6, 20

Red Flags

Rule out pelvic inflammatory disease (pelvic exam if suspected3)

  • Pelvic pain, cervical motion tenderness3,5, 6,, fever3 and adnexal tenderness3,8,, and not pregnant by LMP5
  • Treat partners5, 6, 7, 8, 11

Management

Pelvic inflammatory disease 

  • Ceftriaxone 250-500mg IM once + metronidazole 500mg PO BID 14d + doxycycline 100mg PO BID x14d5, 7, 8, 11
  • Alt: Ciprofloxin 1g once + doxycycline 14d5
  • Alt: Azithromycin 2g PO once + metronidazole 500mg PO BID x14d + doxycycline 100mg PO BID x14d7

Gonorrhea/Chlamydia

  • Treat for both:
    • Gonorrhea: Cipro 500mg or ceftriaxone 125-250mg IM once5, 7, 8, 20 or azithromycin 2g po7, 11, 20
    • Chlamydia – azithromycin 1g PO once, or doxycycline 100mg PO BID x 7-14d5, 7, 8, 20

Trichomonas Vaginitis

  • Metronidazole 500 mg bid for 7-14d or 2g po once5, 6, 8, 11

Bacterial Vaginosis

  • Metronidazole 250-500 mg bid x 7-10 days3,6, 8, 20 or 2g once20 or gel pv daily x5d3,6,
  • Clindamycin 300 mg bid x 7d6, 8, or 2% cream 5g pv at bedtime x 7d6, 8

Candida vaginitis

  • Fluconazole 150mg x13,6, 8, 9, 20 or Clotrimazole 100mg od x 3-14d3,5, 6, 8, 9
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1. Organization A

Locations: Nicaragua
Trips per year: 4
Format of trips: Mobile medical clinics and standing clinics
Setting: Rural
Type of Organization: Secular

2. Organization B

Locations: Guatemala
Trips per year: Variable
Format of trips: Clinics
Setting: Rural
Type of Organization: Secular

3. Organization C

Locations: Haiti
Trips per year: Variable
Format of trips: Clinic
Setting: Urban
Type of Organization: Faith-based

4. Organization D

Locations: Dominican Republic
Trips per year: 3
Format of trips: Clinic
Setting: Rural
Type of Organization: Secular

5. Organization E

Locations: Haiti
Trips per year: 7
Format of trips: Not mentioned
Setting: Rural
Type of Organization: Secular

6. Organization F

Locations: Honduras, Ecuador, Belize, Guyana, Guatemala
Trips per year: 5
Format of trips: Mobile brigades
Setting: Rural and Urban
Type of Organization: Faith-based

7. Organization G

Locations: Ecuador, Guatemala, Dominican Republic
Trips per year: 100 (spread over 6 sites)
Format of trips: Mobile brigades
Setting: Rural and Urban
Type of Organization: Secular

8. Organization H

Locations: Ecuador
Trips per year: 3
Format of trips: Mobile brigades in schools/Clinics in health centers
Setting: Rural
Type of Organization: Secular

9. Organization I

Locations: Honduras
Trips per year: 1
Format of trips: Mobile brigades in 20 villages
Setting: Rural
Type of Organization: Faith-based

10. Organization J

Locations: Jamaica, Haiti
Trips per year: 4
Format of trips: Mobile brigades, Permanent clinics/hospital medicine
Setting: Rural and urban
Type of Organization: Secular

11. Organization K

Locations: Haiti
Trips per year: 4
Format of trips: Clinic
Setting: Rural
Type of Organization: Secular

12. Organization L

Locations: Guatemala, Nicaragua
Trips per year: 3
Format of trips: Mobile clinics
Setting: Rural
Type of Organization: Faith-based

13. Organization M

Locations: Nicaragua, Honduras
Trips per year: 51
Format of trips: Mobile brigades, Hospital-based
Setting: Rural
Type of Organization: Faith-based

14. Organization N

Locations: Guatemala
Trips per year: 12
Format of trips: Hospital
Setting: Rural
Type of Organization: Secular

15. Organization O

Locations: Honduras
Trips per year: Up to 50
Format of trips: Mobile brigades in school and churches
Setting: Rural
Type of Organization: Faith-based

16. Organization P

Locations: Haiti
Trips per year: Variable
Format of trips: Mobile brigades and clinics
Setting: Rural and urban
Type of Organization: Secular

17. Organization Q

Locations: Dominican Republic, Haiti
Trips per year: 12 to 15
Format of trips: Mobile brigades
Setting: Rural
Type of Organization: Secular

18. Organization R

Locations: Honduras, Nicaragua, Panama
Trips per year: Hundreds
Format of trips: Mobile brigades in community centre or school
Setting: Rural
Type of Organization: Secular

19. Organization S

Locations: Honduras
Trips per year: 4
Format of trips: Mobile brigades, Specialty hospital services
Setting: Rural
Type of Organization: Secular

20. Organization T

Locations: Haiti
Trips per year: Approximately 40
Format of trips: Mobile clinics in 14 villages and Standing clinic
Setting: Rural
Type of Organization: Faith-based