Effective clinical diagnosis presents a challenge especially in resource constrained settings due to the fact that the symptoms of many STIs are not specific in nature. Although studies have demonstrated the efficacy of sundromuc management as a choice approach in resource limited countries significant concerns exists. Syndromic management of STIs are plagues with concern of overtreatment, challenge of adequate management of false negative results or patients with dual infections and the long term economic cost among others. The situation even dire for pregnant women with significant risk of adverse birth outcomes.

Syndromic management is an efficient and resource-conservative system.. Potential limitation would be undiagnosed coinfection unresponsive to the chosen treatment approach which may become clinically active at a later time - this includes those infections with longer window periods. As STDs tend to travel in groups coinfection is not uncommon. Antibiotic resistance would be another potential drawback since stewardship protocols of culture and sensitivity-based prescription of drugs is not followed.