The researchers conducted this study to compare women’s management strategies with vaginal discharge in GUM and FP settings.
The setting was a center housing both FP and GUM departments within a primary care trust in Scotland. The study participants were 200 women presenting with vaginal discharge. A randomized, controlled, crossover design was employed. Strategies typical of FP and GUM were performed on every participant in a randomized sequence. Day 1 diagnoses were made by the FP strategy and the GUM strategy. Day 7 results were obtained from the final analysis of all specimens.
On Day 1, the FP strategy resulted in significantly more incorrect diagnoses than the GUM strategy compared with the reference standard. On Day 7, the GUM strategy resulted in substantially more incorrect diagnoses than the FP strategy compared with the reference standard.
Vaginal discharge can be managed effectively in community settings such as FP and primary care. The addition of near-patient microscopy produces a more accurate immediate diagnosis. The addition of a high vaginal swab for culture makes a more precise final diagnosis. The costs of on-site microscopy must be considered.