[Management of sexually transmitted diseases by the syndrome approach and voluntary HIV screening in a specialized dispensary in Antananarivo (Madagascar)].

In 1994, Médecins du Monde opened a free health centre specialized in STD/AIDS in an ill-favored district of Antananarivo, the Malagasy capital of Madagascar. Besides the medical treatment of Sexually Transmitted Diseases (STD) and AIDS, the centre is responsible for the Information, Education and Communication activities (IEC) within and without the centre towards the residents of the 67 hectares district and the high-risk populations (prostitutes, truck-drivers and transvestites). The project aimed at both preventing the spreading of the VIH infection and reducing the incidence of STD. As the Ministry of Health directed, a syndromic method was applied since 1997 regarding STD. Results for 1998 showed the predominance of the association Neisseria gonorrhae-Chlamydiae among the consultants of both sexes. Negative results from 1,218 HIV serological tests carried out seemed confirm the low prevalence of the HIV infection in Madagascar. Yet, the percentage of positive syphilis serology among the tested consultants was lower than that mentioned in previous surveys. Finally, it appears that the syndromic method is of high interest for the countries with limited laboratory capacities.