Accuracy of syndromic management in targeting vaginal and cervical infections among symptomatic women of reproductive age attending primary care clinics in Dakar, Senegal

Objective To assess the effectiveness of the WHO syndromic algorithm in the management of vaginal discharge among women of reproductive age in Dakar. Methods Cross‐sectional study of consecutive female patients (aged 18–49 years) presenting with vaginal symptoms at six selected study sites in Dakar;...

Full description

Saved in:
Bibliographic Details
Published in:Tropical medicine & international health 2018-05, Vol.23 (5), p.541-548
Main Authors: Barry, Mamadou Saidou, Ba Diallo, Awa, Diadhiou, Mohamed, Mall, Ibrahima, Gassama, Omar, Ndiaye Guèye, Mame Diarra, Covi‐Alavo, Serge, Gawa, Epainete, Ndao Fall, Amy, Gaye Diallo, Aissatou, Moreau, Jean Charles
Format: Article
Language:English
Subjects:
Accuracy
Adult
algorithme de l'OMS
Algorithms
Anti-Infective Agents - therapeutic use
Bacteria
Candida albicans
Candidiasis - diagnosis
Candidiasis - drug therapy
Candidiasis - epidemiology
cervical infection
Cervix
Chlamydia
Chlamydia Infections - diagnosis
Chlamydia Infections - drug therapy
Chlamydia trachomatis
Cross-Sectional Studies
Diagnosis
Diagnostic systems
Female
Gardnerella vaginalis
Gonorrhea
Gonorrhea - diagnosis
Gonorrhea - drug therapy
Gonorrhea - epidemiology
Health care
Humans
infection cervicale
infection vaginale
Infections
Laboratories
Mathematical models
Middle Aged
Neisseria
Patients
pertes vaginales
prise en charge syndromique
Risk Assessment
Senegal
Sensitivity analysis
Sexually transmitted diseases
Specificity
STD
Symptoms
syndromic case management
Trichomonas vaginalis
Trichomonas Vaginitis - diagnosis
Trichomonas Vaginitis - epidemiology
Vagina
Vaginal Discharge
vaginal infection
Vaginosis, Bacterial - diagnosis
Vaginosis, Bacterial - drug therapy
Vaginosis, Bacterial - epidemiology
WHO algorithm
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective To assess the effectiveness of the WHO syndromic algorithm in the management of vaginal discharge among women of reproductive age in Dakar. Methods Cross‐sectional study of consecutive female patients (aged 18–49 years) presenting with vaginal symptoms at six selected study sites in Dakar; of these, 276 patients were included in the analysis. Vaginal and cervical swab samples were collected and analysed to establish an aetiological diagnosis of any infection. Syndrome‐based diagnosis was compared with the laboratory results to evaluate its accuracy based on sensitivity, specificity and positive and negative predictive values. The degree of agreement between the two approaches was assessed using the Cohen's kappa concordance analysis. Results Overall prevalence of vaginal infections was 56.9% (157/276); 5.4% (15/276) of the patients had cervical infection. Using the syndromic approach, 51% of patients were correctly managed for Trichomonas vaginalis (TV)/Gardnerella vaginalis (GV); 61% for Candida albicans (CA) and 54% for Chlamydia trachomatis (CT)/Neisseria gonorrhoea (NG) infections. Consequently, 31% of patients with TV/GV, 51% with CA and 53% with CT/NG infections would have missed treatment. Further, the kappa value was
ISSN:1360-2276
1365-3156
DOI:10.1111/tmi.13046