STI guidelines get revamp after 14 years
Cases surge in last five years
Wide-ranging changes to the sexually transmitted infection (STI) guidelines, last reviewed over a decade ago, were announced last week.The health ministry, the United States Agency for International Development (USAID) and the United States President's Emergency Plan for AIDS Relief (Pepfar) unveiled the changes, with minister Dr Kalumbi Shangula saying the move was necessitated by the increase in STI related cases in the country over the last five years.
"Over the past five years, on average, more than 96 000 cases of STIs were recorded at our health facilities around the country every year," he said.
This comes after Namibia made remarkable strides regarding HIV/AIDS.
"The country has set ambitious targets to reach 97-97-97 on the cascade by 2028. These successes demonstrate what is possible when we work together to tackle challenges.
“I believe that, through deliberate interventions and programmes, it is possible to successfully reduce the STI burden in our country," he added.
Changes
The ministry's clinical mentor, Dr Leonard Bikinesi, said the guidelines needed to change to accommodate changes in the STI landscape.
"In the past five years, Namibia has reported a constant increase in the trend of STIs, notably urethral discharge syndrome. This is a public health challenge as STIs not only cause reproductive and psychological health impacts, but also facilitate the acquisition of HIV.
“In addition, there was a need to align the management of STIs to the latest available evidence," he said.
Changes in the guidelines include adjustments in medication dosage and treatment duration.
Bikinesi highlighted that scientific evidence has since shown that some people may be carrying asymptomatic infections, which prompted the change in singular syndromic management focus in the new guidelines.
Pregnant women, who used to be screened for syphilis only once, will now be tested during their first antenatal care visit and again at 34 weeks.
Stigma
Shangula said the new treatment guidelines are aligned with the UNAIDS Global AIDS Strategy 2021–2026, which aims to reduce the inequalities that "drive the AIDS epidemic and prioritise people who are not yet accessing life-saving HIV services”.
"Equally importantly, the guideline emphasises the importance of early detection, comprehensive treatment and robust prevention strategies," he said.
The guidelines further highlight and recognise the need to address both social and cultural nuances which contribute to stigma around STIs, he said.
“By working together, we can foster an environment where open dialogue, understanding and support thrive," he said.