Value of clinical algorithms to screen for gonococcal and chlamydial infection among women attending antenatal and family planning clinics

Wilkinson, D. and Sturm, A.W. (1998) Value of clinical algorithms to screen for gonococcal and chlamydial infection among women attending antenatal and family planning clinics. South African Medical Journal, 88 7: 900-905.

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Author Wilkinson, D.
Sturm, A.W.
Title Value of clinical algorithms to screen for gonococcal and chlamydial infection among women attending antenatal and family planning clinics
Journal name South African Medical Journal   Check publisher's open access policy
ISSN 0256-9574
Publication date 1998-07-01
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 88
Issue 7
Start page 900
End page 905
Total pages 6
Place of publication Pinelands, South Africa
Publisher Medical Association of South Africa
Language eng
Subject 1103 Clinical Sciences
1108 Medical Microbiology
1117 Public Health and Health Services
Formatted abstract
Objectives.
To determine the value of using KwaZulu-Natal Provincial Health Department algorithms for sexually transmitted disease (STD) treatment to detect infection with Neisseria gonorrhoeae and/or Chlamydia trachomatis among women attending antenatal and family planning clinics.

Methods.
327 women attending antenatal clinics and 189 attending a family planning clinic in Hlabisa, KwaZulu-Natal, were questioned and examined clinically and microbiologically. Data were used to determine the sensitivity, specificity and predictive values of the algorithm used with a speculum and the algorithm when no speculum was available.

Results.

Prevalence of infection with N. gonorrhoeae and/or C. trachomatis was high among both pregnant women (18.9%) and those attending the family planning clinic (11.1%). Associations between abnormal symptoms and signs and infection were weak, odds ratios ranging from 1.1 to 5.4. Both algorithms performed poorly, with sensitivity ranging from 42.9% to 70.0%, specificity from 30.7% to 75.6%, and positive predictive values from 17% to 18.8%.

Conclusions.
Prevalence of infection is high among these women. The algorithms tested perform poorly - most infected women remain untreated and most of those treated are uninfected. Alternative strategies for diagnosis and/or treatment are required.
Keyword Sexually-transmitted Diseases
Pelvic Inflammatory Disease
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 07 Sep 2010, 23:08:40 EST