W075 Accuracy of Syndromic Diagnosis and Management for Vaginal Discharge and Cervicitis in Women of Reproductive Age in Bogota, Colombia

Tolosa, Juán; Rodriguez, A.E.; Müller, EC; Ruíz-Parra, Ariel Iván; Nuñez-Forero, L.; Moyano, Luisa F; Gaitán-Duarte, Hernando

doi:10.1016/s0020-7292(12)61800-1

Cited by 4 publications

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“…This may be a potential for publication bias and should be taken into account. Sixteen studies were selected in the final review [ 23 – 39 ]. These studies distinguished between cervical infections due to NG and CT and vaginal infection due to TV and BV during their research and analysis.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The Performance of the Vaginal Discharge Syndromic Management in Treating Vaginal and Cervical Infection: A Systematic Review and Meta-Analysis

Zemouri

Kiarie

et al. 2016

PLoS ONE

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BackgroundThis review aimed to synthesize and analyze the diagnostic accuracy and the likelihood of providing correct treatment of the syndromic approach Vaginal Discharge Flowchart in managing cervical infections caused by Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), and vaginal infections caused by Trichomonas vaginalis (TV) and Bacterial vaginosis (BV) and Candida albicans. This review will inform updating the WHO 2003 guidelines on Vaginal Discharge syndromic case management.MethodsA systematic review was conducted on published studies from 01-01-2000 to 30-03-2015 in multiple databases. Studies evaluating the diagnostic accuracy and validation of the WHO Vaginal Discharge Flowchart were included. Validation parameters including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and the 95% confidence intervals for the different types of the flowchart were taken as outcomes, re-calculated, and analysed using a fixed model meta-analysis for data pooling. The level of agreement between the index and reference test were determined by the Cohen’s Kappa co-efficiency test. Each individual study was assessed on quality using the QUADAS-2 tool.FindingsThe search yielded 2,845 studies of which 16 met the eligibility criteria for final analysis. The diagnostic performance to identify cervical infections was low and resulted in a high proportion of over and missed treatment. The four flowcharts had a sensitivity between 27.37% in history and risk assessment and 90.13% with microscopy, with the inverse in specificity rates. The treatment performances between the flowcharts were inconsistent. The same applies to the use of vaginal discharge flowchart for treating vaginal infections. For vaginal infections the vaginal discharge flowchart had a good performance in flowchart 3 with 91.68% of sensitivity; 99.97% specificity; 99.93% PPV and 0.02% who missed their treatment and 8.32% of women who were over treated by the vaginal discharge flowchartConclusionThe vaginal discharge flowchart should focus on management of vaginal infection. It could be used as an intermediate approach for cervical infections for sex workers until a point of care test is available in resource poor settings.

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Section: Resultsmentioning

confidence: 99%

“…Prevalence rates vary per study: TV ranged from 0.9% in Colombia [ 39 ] to 17.3% in Uganda [ 38 ]. BV ranged from 39% in Colombia [ 39 ] to 47.7% in Uganda [ 38 ]. The diagnostic accuracy rates and performance per flowcharts for identifying TV and BV are summarized in Table 5 .…”

Section: Resultsmentioning

confidence: 99%

The Performance of the Vaginal Discharge Syndromic Management in Treating Vaginal and Cervical Infection: A Systematic Review and Meta-Analysis

Zemouri

Kiarie

et al. 2016

PLoS ONE

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“…This is a planned secondary analysis of a study to evaluate the use of syndromic diagnosis of LUTIs 11. The design was a cross-sectional study involving sexually active women aged between 14 years and 49 years, having LUTI symptoms, such as vaginal discharge, foul odour or itching, who consulted at a private sexual and reproductive health clinic (PROFAMILIA) and at the ambulatory services of two public general hospitals: Engativá and Fontibón Hospitals, in Bogotá, Colombia, during 2010.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic accuracy of rapid tests for sexually transmitted infections in symptomatic women

et al. 2015

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“…Se ha encontrado que la sensibilidad del manejo sindrómico para el diagnóstico de infección cervical es de 13,3%. Además, el flujo vaginal reportado por la paciente y encontrado en el examen clínico es el signo más sensible para el diagnóstico sindrómico con un 49,7 y 78,3% de sensibilidad y especificidad respectivamente (49).…”

Section: ¿Cuáles Son Las Manifestaciones Clínicas De Las Its/itg Caraunclassified

“…Para el diagnóstico de las patologías asociadas al síndrome de flujo vaginal se han descrito varios signos y síntomas que incluyen descarga vaginal fétida la cual es más frecuente en la vaginosis bacteriana, flujo de color amarillo en la TV y prurito vaginal o vulvar, eritema vaginal o vulvar y disuria, estos últimos síntomas son más frecuentes en la candidiasis (8,49). El manejo sindrómico inicial no incluye la realización de pruebas de laboratorio.…”

Section: ¿Cuáles Son Las Manifestaciones Clínicas De Las Its/itg Caraunclassified

Guía de práctica clínica para el manejo sindrómico de los pacientes con infecciones de transmisión sexual y otras infecciones del tracto genital - 2013

Gaitán-Duarte

Rodríguez-Hernández

Arévalo-Rodríguez

et al. 2013

Rev. Colomb. Obstet. Ginecol.

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W075 Accuracy of Syndromic Diagnosis and Management for Vaginal Discharge and Cervicitis in Women of Reproductive Age in Bogota, Colombia

Cited by 4 publications

References 0 publications

The Performance of the Vaginal Discharge Syndromic Management in Treating Vaginal and Cervical Infection: A Systematic Review and Meta-Analysis

The Performance of the Vaginal Discharge Syndromic Management in Treating Vaginal and Cervical Infection: A Systematic Review and Meta-Analysis

Diagnostic accuracy of rapid tests for sexually transmitted infections in symptomatic women

Guía de práctica clínica para el manejo sindrómico de los pacientes con infecciones de transmisión sexual y otras infecciones del tracto genital - 2013

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