Knowledge, attitudes and practices of doctors at Jubilee Hospital, Tshwane District, regarding the syndromic management guidelines for sexually transmitted infections

Figures & data

Table 1: Baseline characteristics of the participants

Characteristics	Frequency (n = 43)	Percentage (%)
Sex:
Male	23	53.5
Female	20	46.5
Age group (years):
25–30	13	30.2
31–35	8	18.6
36–40	14	32.6
Above 40	8	18.6
Age: Mean = 35.3 SD = 6.18 Median = 36 Min. = 25 Max. = 48
Marital status:
Living together	5	11.6
Married	26	60.5
Single	12	27.9
Education:
Bachelor’s degree only	36	83.7
Master’s	3	7
Additional qualification(s)	4	9.3
Years of practice:
< 5	12	27.9
6–10	17	39.5
11–15	14	32.6

Table 2: Knowledge of the SM guidelines for STIs

Factor	Frequency (n = 43)	Percentage (%)
Have you previously heard of STI guidelines?
Yes	39	90.7
No	4	9.3
Period when heard of STIs (n = 29):
During medical school	11	37.9
Post-medical school	18	62.1
Source of knowledge of the SM guidelines:
Radio	1	2.3
Medical textbooks	17	39.5
Seminar	4	9.3
Medical journal	10	23.3
Colleague	14	32.6
Other	4	9.3
Have knowledge of the different STI syndromes:
Yes	39	90.7
No	4	9.3
Knowledge of the age group at highest risk for STIs:
Youth (13–25 years)	21	48.8
Adult (26–38 years)	22	51.2

Table 3: Knowledge of the organisms causing STIs and syndrome abbreviations

Knowledge question	High (scores of 8–10)	Moderate (scores of 5–7)	Low (scores of 0–4)
Doctors’ knowledge of organisms causing STIs	0 (0%)	34 (79.1%)	9 (20.9%)
Doctors’ knowledge of STI syndrome abbreviations	19 (44.2%)	17 (39.5%)	7 (16.3%)

Table 4: STI syndromes and causative organisms

Specific STI syndrome and responsible causative organism(s)	Correct	Incorrect
Causes of genital ulcers (n = 43)	37 (86.0%)	6 (14.0%)
Causes of vaginal discharge (n = 41)	39 (95.1%)	2 (4.7%)
Cause of painful scrotal swelling (n = 43)	14 (32.6%)	29 (67.4%)
Causes of mucopurulent discharge of the cervix/urethra (n = 43)	39 (90.7%)	4 (9.3%)

Table 5: Knowledge of the SM of MUS and GUS

MUS		Name of drug
		Cefixime n (%)	Doxycycline n (%)	Metronidazole n (%)
	Correct	7 (16.3)	27 (62.8)	3 (7.0)
	Incorrect	36 (83.7)	16 (37.2)	40 (93.0)
	Total	43 (100.0)	43 (100.0)	43 (100.0)
Amongst those who stated drug name correctly:
		n = 7 (%)	n = 27 (%)	n = 3 (%)
Dose	Correct	7 (100.0)	27 (100.0)	2 (66.7)
Frequency	Correct	7 (100.0)	27 (100.0)	2 (66.7)
Duration	Correct	7 (100.0)	27 (100.0)	2 (66.7)
Management syndrome: GUS (sexually active within the last 3 months)		Name of drug
		Benzathine penicillin n (%)	Erythromycin n (%)	Acyclovir n (%)
	Correct	21 (48.8)	4 (9.3)	6 (14.0)
	Incorrect	22 (51.2)	39 (90.7)	37 (86.0)
	Total	43 (100.0)	43 (100.0)	43 (100.0)
Amongst those who stated the correct drug:
		n = 21 (%)	n = 4 (%)	n = 6 (%)
Dose	Correct	21 (100.0)	4 (100.0)	5 (83.3)
Frequency	Correct	21 (100.0)	4 (100.0)	5 (83.3)
Duration	Correct	19 (90.5)	3 (75.0)	5 (83.3)
GUS (not sexually active within the last 3 months)		Frequency	Percentage
Acyclovir	Correct	13	30.2
	Incorrect	30	69.8
	Total	43	100.0
Amongst those who stated the correct drug (n = 13):
Dose	Correct	11	84.6
Frequency	Correct	10	76.9
Duration	Correct	11	84.6

Table 6: Most effective source of information with regard to STI control, treatment of STIs and risk of HIV transmission

Factor	Frequency (n = 43)	Percentage (%)
Single most effective source of information to the public with regard to control of STIs:
Mass media (radio, television and newspapers)	25	61.0
Education by doctors and other healthcare providers	16	39.0
Appropriate treatment and control of STIs decreases the risk of HIV transmission:
Agree	38	90.5
Disagree	4	9.5

Table 7: Attitudes and perceptions of doctors towards SM guidelines

Factor	Frequency	Percentage (%)
Doctors’ satisfaction with the current national SM guidelines for STIs (n = 39):
Satisfied	34	87.2
Not satisfied	5	12.8
Doctors’ interest in attending continuing medical education seminars on STI control (n = 42):
Interested	39	92.9
Not interested	3	7.1
Doctors’ STI management practices:
Diagnosis of STIs (n = 42):
Using only history and physical examination	22	52.4
Using history, clinical evaluation, microscopy and/or culture	20	47.6
Asking questions about sexual practices (n = 41):
Yes	35	85.7
No	6	14.3

Table 8: Doctors’ practices with regard to STI prevention and health promotion

Factor	Always n (%)	Sometimes n (%)	Never n (%)
Asking patients about the number of sexual partners (n = 42)	7 (16.7)	30 (71.4)	5 (11.9)
Examination of the genitals of patients suffering from STIs (n = 42)	23 (54.8)	18 (42.8)	1 (2.4)
Filling of the partner notification slips after attending to the index patient (n = 42)	4 (9.5)	32 (76.2)	6 (14.3)
Counselling for HIV testing (n = 41)	21 (51.2)	20 (48.8)	0 (0)

Table 9: Doctors’ knowledge, attitudes and practices by sex and age

Factor		Good/optimal (> 70%)	Satisfactory/average (40–70%)	Poor/suboptimal (< 40%)	p-value
Doctors’ knowledge:
Sex	Female	2 (10.0)	17 (85.0)	1 (5.0)	0.267
	Male	5 (21.7)	14 (60.9)	4 (17.4)
Doctors’ attitude
Sex	Female	19 (95.0)	0 (0.0)	1 (5.0)	0.465
	Male	23 (100.0)	0 (0.0)	0 (0.0)
Doctors’ practice
Sex	Female	1 (5.0)	13 (65.0)	6 (30.0)	0.861
	Male	0 (0.0)	16 (69.6)	7 (30.4)
Doctors’ knowledge, attitudes and practices in relation to their age:
Doctors’ knowledge:
Age (years)	20–29	1 (14.3)	6 (85.7)	0 (0.0)	0.005^a
	30–39	5 (20.0)	20 (80.0)	0 (0.0)
	40–49	1 (9.1)	5 (45.5)	5 (45.5)
Doctors’ attitude:
Age (years)	20–29	7 (100.0)	0 (0.0)	0 (0.0)	1.000
	30–39	24 (96.0)	0 (0.0)	1 (4.0)
	40–49	11 (100.0)	0 (0.0)	0 (0.0)
Doctors’ practice:
Age (years)	20–29	1 (14.3)	4 (57.1)	2 (28.6)	0.471
	30–39	0 (0.0)	17 (68.0)	8 (32.0)
	40–49	0 (0.0)	8 (72.7)	3 (27.3)

^aStatistically significant.