Marginal validity of syndromic management for reproductive tract infections among pregnant women in Jamaica.

Hylton-Kong T, Brathwaite AR, Del Rosario GR, Kristensen S, Kamara P, Jolly PE, Hook EW, Figueroa JP, Vermund SH
Int J STD AIDS. 2004 15 (6): 371-5

PMID: 15186580 · DOI:10.1258/095646204774195209

We assessed the validity of a syndromic case management approach for reproductive tract infections (RTIs) among 371 pregnant women attending antenatal care facilities in Kingston, Jamaica, using an algorithm previously validated in high-risk Jamaican women. For our antenatal attenders, the algorithm had low sensitivities for all RTIs (66.7% for cervicitis, 35.4% for trichomoniasis, 11.1% for bacterial vaginosis (BV) and 24% for candidiasis). Specificities for BV (88.9%) and candidiasis (81.1%) were higher than for cervicitis (62.8%) and trichomoniasis (68.5%). The positive predictive values were lower than 36% for all diagnoses, especially BV (6.9%). Syndromic management of RTIs in pregnant women was problematic using a clinical algorithm that had worked well for high-risk women. Syndromic management for RTIs in Jamaican antenatal clinics is only a temporary solution until more simple and affordable diagnostic tests for RTIs are developed and/or until laboratory support and clinical care can be upgraded at antenatal clinics.

MeSH Terms (14)

Adolescent Adult Algorithms Ambulatory Care Facilities Female Humans Jamaica Predictive Value of Tests Pregnancy Pregnancy Complications, Infectious Prenatal Care Sensitivity and Specificity Uterine Cervicitis Vaginal Diseases

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