Nuwaha 2001.

Methods	Setting: Mulago Hospital STI clinic in Kampala, Uganda treats patients free of charge. Clinic is the main STI reference centre, mainly serves as a walk‐in primary care STI treatment centre Enrolment: consecutive patients with STI symptoms enrolled between November 1999 and January 2000 Follow‐up: index patients were asked to return to the clinic within 2 weeks
Participants	383 index patients (196 men, 187 women) with STI symptoms were randomised Inclusion criteria: STI symptoms presented for the first time Sexual intercourse in previous 3 months or for the period with STI symptoms Female patients with vaginal discharge were included, if on examination with speculum cervical discharge was present, or if they had vaginal discharge associated with genital ulcer or with Trichomonas vaginalis Exclusion criteria Partners already had treatment Partners lived too far to be reached within 1 month Female patients were diagnosed with only candida infections or bacterial vaginosis
Interventions	All index patients were given information, education and communication for 5‐10 minutes. Trained research assistants performed interviews using a pre‐tested questionnaire Simple patient referral (n = 191) Index patients were given contact slips to take to sexual partners. Index patient asked to return 2 weeks later EPT (n = 192) Index patients were given medications to take to sexual partners. Index patient were asked to return after 2 weeks. Index patients were request to return medication if their partners refused them or if they could not trace the partner
Outcomes	Partners (regular and casual) treated (contact slips returned, all patients attending the clinic were asked if they were referred, index patients records were reviewed to link partners to index patients, at 2‐week follow‐up index patient was asked if partners were treated) Partners (regular and casual) elicited (self report by index patient) Index patient 2‐week post‐treatment return (clinic records) Adverse reactions such as quarrelling, fighting and refusal of sexual intercourse (index patient report at 2‐week interview) Side effects of drugs (index patient report at 2‐week interview)
Notes	Ethics approval by Mbarara University, the Faculty of Medicine Research Committee, the Uganda AIDS Committee, the Uganda National Council for Science and Technology, and the Ethics Research Committee at Karolinska Institute (Stockholm, Sweden). Permission to conduct the study was obtained from the Mulago Hospital administration
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated random number between 0 and 999; even numbers to EPT group, and odd numbers were assigned to the patient‐based partner referral group. Stratified randomisation according to the sex of the index patient was used
Allocation concealment (selection bias)	Unclear risk	No detail of allocation concealment given
Incomplete outcome data (attrition bias) All outcomes	Low risk	ITT analysis was used. In EPT, 187/192 (97%) index patients returned after 2 weeks and in simple patient referral 117/191 (61%) returned. On return, participants reported on partner treatment and partner reaction. Attrition bias in the simple patient referral arm
Selective reporting (reporting bias)	Low risk	Outcomes reported in methods section were reported in results section. Protocol not available from 3 trial registries
Other bias	Unclear risk	Partners of participants in simple patient referral group could have been treated elsewhere leading to misclassification bias
Blinding of participants and personnel (performance bias) All outcomes	High risk	Blinding not possible
Blinding of outcome assessment (detection bias) All outcomes	High risk	Partners in simple patient referral group returned coded slips. Clinic workers checked clinic records for all patients who said they had been referred by a partner to attempt to link them to an index patient. In addition, they collected reports from index patients on partner referral (not analysed in this review) In the EPT participants, the outcome was index patient reports whether partner took medication. This can introduce detection bias