{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:10:14Z","timestamp":1778285414104,"version":"3.51.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0014282","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000}}],"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004916","name":"Funda\u00c3\u00a7\u00c3\u00a3o de Amparo \u00c3\u00a0 Pesquisa do Estado do Amazonas","doi-asserted-by":"publisher","award":["grant #010\/2023"],"award-info":[{"award-number":["grant #010\/2023"]}],"id":[{"id":"10.13039\/501100004916","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004916","name":"Funda\u00c3\u00a7\u00c3\u00a3o de Amparo \u00c3\u00a0 Pesquisa do Estado do Amazonas","doi-asserted-by":"publisher","award":["grant #010\/2023"],"award-info":[{"award-number":["grant #010\/2023"]}],"id":[{"id":"10.13039\/501100004916","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The syndromic approach is a widely applied strategy for managing sexually transmitted infections (STIs) in settings where laboratory diagnostics are limited. This study aimed to describe temporal patterns in syndromic STI diagnoses and identify factors independently associated with these diagnoses over a period of 10 years at a reference center in the state of Amazonas, Brazilian Amazon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/Principal findings<\/jats:title>\n                    <jats:p>A retrospective review was conducted using medical records from patients attending a reference center for STI care in Amazonas, Brazil, from 2014 to 2023. Sociodemographic, clinical, and behavioral data were analyzed. The syndromic classification followed World Health Organization guidelines and included vaginal discharge, cervical discharge, urethral discharge, genital ulcers, and genital warts. A total of 32,485 medical records were reviewed, with 14,931 (46.0%) syndromic diagnoses identified. The most frequent syndromes were genital warts (41.0%), urethral discharge (31.5%), genital ulcer (21.3%), cervical discharge (3.8%), and vaginal discharge (2.3%). In multivariate analysis, factors independently associated with receiving a syndromic diagnosis were age\u2009\u2265\u200930 years (OR = 1.16; 95% CI: 1.05\u20131.20), male sex (OR = 2.31; 95% CI: 1.75\u20132.45), single marital status (OR = 1.82; 95% CI: 1.43\u20132.21), irregular condom use (OR = 3.21; 95% CI: 2.46\u20133.60), and having two or more casual partners (OR = 3.42; 95% CI: 2.94\u20133.90).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions\/Significance<\/jats:title>\n                    <jats:p>Despite inherent limitations, the syndromic approach remains an essential strategy for STI control in resource-constrained contexts such as the Amazon. It facilitates prompt treatment and broadens access to care where laboratory confirmation is unavailable. Integrating syndromic and etiological approaches is vital to improve diagnostic accuracy, optimize antimicrobial use, and strengthen public health responses to STIs in the region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014282","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:47:25Z","timestamp":1777916845000},"page":"e0014282","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Syndromic management of sexually transmitted infections in the Brazilian Amazon: A 10-year retrospective study"],"prefix":"10.1371","volume":"20","author":[{"given":"Ana Claudia","family":"Chaves Camilo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valderiza Louren\u00e7o","family":"Pedrosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Carlos","family":"Sardinha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvana Paiva da","family":"Costa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cel\u00edlia de Lima","family":"Borges","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelica Espinosa","family":"Miranda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Bind\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9 Luiz","family":"Leturiondo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camila Gurgel","family":"dos Santos Silva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia de Oliveira","family":"Ferreira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria das Gra\u00e7as Barbosa","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinesio","family":"Talhari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2283-069X","authenticated-orcid":true,"given":"Carolina","family":"Talhari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"pntd.0014282.ref001","article-title":"Diagnosing sexually transmitted infections in resource-constrained settings: challenges and ways forward","author":"TE Wi","year":"2019","journal-title":"J Int AIDS Soc"},{"key":"pntd.0014282.ref002","volume-title":"Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021[Internet]","author":"World Health Organization","year":"2021"},{"key":"pntd.0014282.ref003","volume-title":"Protocolo Cl\u00ednico e Diretrizes Terap\u00eauticas para Aten\u00e7\u00e3o Integral \u00e0s Pessoas com Infec\u00e7\u00f5es Sexualmente Transmiss\u00edveis (IST) [Internet]","author":"Brasil","year":"2021"},{"key":"pntd.0014282.ref004","unstructured":"World Health Organization. Guidelines for the management of symptomatic sexually transmitted infections[Internet]. Geneva: WHO; 2021 [cited 2025 Jan 31]. 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