Management of anogenital warts in STD clinic, Kalubowila: a clinical audit

Introduction: Genital wart (GW) is the 3rd leading Sexually Transmitted disease (STD) in Sri Lanka which accounts for 23% of total reported STDs.

Objective: To describe the management of GW at STD clinic, Kalubowila in relation to the national guideline.

Methods: One hundred and thirty nine consecutive patient records during year 2016, with genital warts were analyzed using a data extraction sheet for auditable outcome variables adapted from the audit group of British Association of Sexual Health and HIV (BASHH).

Results: Out of 139 records, 86 were males and 53 were females. All the patients were managed according to the Sri Lankan national guideline. In almost all the cases (96%), site/location of the warts and extent/ distribution of the warts had been recorded using diagrams. However, the lesion was described in 50% of records. Out of female patients (53), cervical cytology was done in 31 patients (58%) and CIN 1 was reported in 2 cases. Pap smear had not been done in 40% of patients by the STD clinic due to pregnancy, total hysterectomy and availability of recent Pap test. All the patients were screened for HIV, syphilis and gonorrhoea. Trichloroacetic acid (90% TCA) and Cryo-theapy were the first line treatment among 75% and 25% of patients respectively. Three month treatment response rate was 74% while 9% did not show an adequate response and rest (17%) were defaulted treatment.

Conclusion: Almost all the patients were managed according to the national guideline and this should be continued. However, treatment response rate needs to be improved availing more treatment options.