{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:43:14Z","timestamp":1777927394081,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>Vulvovaginal candidiasis (VVC), a common cause of vaginitis, affects 75% of women in their lifetime. In Kenya, vaginitis\/VVC is managed using the vaginal discharge syndrome guidelines. We assessed how frequently healthcare workers consider the diagnosis of vaginitis\/VVC in symptomatic women, and adherence to the syndromic guidelines, outpatient records at Nairobi City County health facilities, of non-pregnant symptomatic females aged \u226515\u00a0years were abstracted. Descriptive statistics were applied, and analysis of determinants of practice determined using multivariable logistic regression models. Of 6,516 patients, 4,236 (65%) (inter-facility range 11\u201392%) had vaginitis of which 1,554 (37%) were considered VVC (inter-facility range 0\u201399%). Vaginitis was associated with facility, adjusted odds ratio (aOR) 2.80 (95% confidence interval (CI) 1.64\u20134.76) and aOR 0.03 (95% CI 0.02\u20130.04); and month, aOR 0.33 (95% CI 0.25\u20130.43). Vaginal examination was in 53% (inter-facility range 0\u201398%). Adherence to syndromic treatment was 56% (inter-facility range 0\u201383%), better with older patients (aOR 7.73, 95% CI 3.31\u201318.07). Vaginitis and VVC are commonly diagnosed in symptomatic patients in Nairobi; adherence to the syndromic guidelines is low and differs across the health facilities. Interventions to improve adherence are needed.<\/jats:p>","DOI":"10.1177\/09564624221087533","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T11:02:07Z","timestamp":1649156527000},"page":"584-596","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Inadequacies in service delivery for the diagnosis and treatment of vaginitis and vaginosis in Nairobi, Kenya"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4019-8977","authenticated-orcid":false,"given":"Gloria S","family":"Omosa-Manyonyi","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucina N","family":"Koyio","sequence":"additional","affiliation":[{"name":"Nairobi City County, Health Services, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther W","family":"Mwangi","sequence":"additional","affiliation":[{"name":"Nairobi City County, Health Services, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Gathura","sequence":"additional","affiliation":[{"name":"Nairobi City County, Health Services, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andre","family":"van der Ven","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Nijmegen, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaap ten","family":"Oever","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Nijmegen, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"bibr1-09564624221087533","first-page":"0815","volume":"2015","author":"Martin Lopez JE","year":"2015","journal-title":"BMJ Clin Evid"},{"key":"bibr2-09564624221087533","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000771"},{"key":"bibr3-09564624221087533","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4549-3"},{"key":"bibr4-09564624221087533","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0163365"},{"key":"bibr5-09564624221087533","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa260"},{"key":"bibr6-09564624221087533","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30103-8"},{"key":"bibr7-09564624221087533","doi-asserted-by":"publisher","DOI":"10.3109\/1040841X.2015.1091805"},{"key":"bibr8-09564624221087533","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2012.011382"},{"key":"bibr9-09564624221087533","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2747-4"},{"key":"bibr10-09564624221087533","doi-asserted-by":"publisher","DOI":"10.1136\/sti.76.1.33"},{"key":"bibr11-09564624221087533","doi-asserted-by":"publisher","DOI":"10.4236\/ojmm.2013.34040"},{"key":"bibr12-09564624221087533","volume-title":"Guidelines For the Management of Sexually Transmitted Infections","author":"World Health Organization","year":"2003"},{"key":"bibr13-09564624221087533","volume-title":"Kenya National Guidelines for Prevention, Management and Control of Sexually Transmitted Infections 2006. 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