The goal of this clinical trial is to examine if and how the implementation of point-of care-tests (POCT) for sexually transmitted infections in the management of abnormal vaginal discharge reduces the overtreatment with antibiotics in a low income country. The setting is a university hospital in a semi-rural area in Nepal and several of its rural out-reach-centers. The plan is to include 1500 women attending the gynecological outpatients with a problem of vaginal discharge over approximately a one year period. The main questions the clinical trial aims to answer are: * Does POCT guided treatment result in reduced over-treatment of antibiotics, compared to the current approach in Nepal? * What are the barriers and facilitators of the acceptability of POCTs and the resulting treatment from the perspective of both patients and health care practitioners? Participants will be randomized in three groups: * standard treatment according to current practice * POCT result based treatment * POCT result based treatment plus patient education and addressing of psycho social vulnerabilities
Age range
18 Years – 60 Years
Sex
FEMALE
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Proportion of participants overtreated with antibiotics (excluding antifungals)
Timeframe: At inclusion
Proportion of participant prescribed antimicrobial resistance driving antibiotics
Timeframe: At inclusion.
Proportion of participants adhering to treatment recommendations
Timeframe: At telephonic follow up after 1 month.