• Login
    • Login
    Advanced Search
    View Item 
    •   AMREF IR Home
    • Research Papers
    • General - GEN
    • General - GEN
    • View Item
    •   AMREF IR Home
    • Research Papers
    • General - GEN
    • General - GEN
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Validation of a WHO Algorithm with Risk Assessment for the Clinical Management of Vaginal Discharge in Mwanza, Tanzania

    Thumbnail
    View/Open
    Research article (786.7Kb)
    Publication Date
    1998-07
    Authors
    Mayaud, Philippe
    ka-Gina, Gina
    Cornelissen, Jan
    Todd, James
    Kaatano, Godfrey
    West, Beryl
    Uledi, Elizabeth
    Rwakatare, Medard
    Kopwe, Lilian
    Manoko, Domitilia
    Laga, Marie
    Grosskurthy, Heiner
    Hayes, Richard
    Mabe, David
    Show More
    (14 total)
    Type
    Article, Journal
    Item Usage Stats
    7
    views
    4
    downloads
    Metadata
    Show full item record
    Citation

    Mayaud, P., ka-Gina, G., Cornelissen, J., Todd, J., Kaatano, G., West, B., Uledi, E., Rwakatare, M., Kopwe, L., Manoko, D., Laga, M., Grosskurth, H., Hayes, R., & Mabey, D. (1998). Validation of a WHO algorithm with risk assessment for the clinical management of vaginal discharge in Mwanza, Tanzania. Sexually transmitted infections, 74 Suppl 1, S77-84 .

    Abstract/Overview

    Objectives: (i) To determine the microbial aetiologies of vaginal discharge in STD clinic and antenatal clinic (ANC) attenders; (ii) to evaluate the performance and costs of a new WHO algorithm for the detection of gonococcal and chlamydial infections in women complaining of vaginal discharge and/or genital itching, using a risk assessment. Methods: Two groups were enrolled: (i) 395 consecutive female patients attending a hospital outpatient clinic complaining of genital discharge or itching; and (ii) 628 consecutive pregnant women reporting at an urban ANC these symptoms. Patients were interviewed by a nurse, who applied the WHO risk score. They were then referred to the study room for interview concerning the same and other risk factors, examined, and sampled for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Trichomonas vaginalis (TV), and Candida albicans (CA). Sensitivity, specificity, positive predictive value, overtreatment and correct treatment rates, and cost of drugs per true case treated were estimated. Results: The prevalence of NG and/or CT infections was 11.4% and 8% at the STD clinic and the ANC respectively. The most prevalent pathogens were CA (38% at both clinics) and TV (25% at the STD clinic and 34% at the ANC). The sensitivity of the WHO algorithm for NG and/or CT was 62% at the STD clinic and 46% at the ANC, and the specificities were 64% and 84% respectively. The operational feasibility of the method was good. The cost of drugs per true case treated in applying the risk assessment approach was $3.5 among nonpregnant women and $5.0 among pregnant women. This compared favourably with respective costs of $8.8 and $25.0 in applying the syndromic management alone. Conclusions: The WHO risk assessment algorithm for the diagnosis of NG and/or CT infections among women complaining of genital discharge can considerably reduce overtreatment of NG and/or CT in both pregnant and non-pregnant women, but in this study it failed to identify 38% of non-pregnant and 54% of pregnant women with these infections. The elements of the risk score may need adjustment in different settings.

    Subject/Keywords
    Vaginal discharge; Gonorrhoea; Chlamydial infection; STD algorithms; Risk assessment; Tanzania
    Publisher
    Sexually Transmitted Infections
    Permalink
    http://repository.amref.org/handle/123456789/220
    Collections
    • General - GEN [355]

    Amref International University. All rights reserved | Copyright © 2021 
    Contact Us | Send Feedback

     

     

    Quick Links
    Amref International UniversityAmref Health AfricaKLISC

    Browse

    All of AMREF IRCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsTypeThis CollectionBy Issue DateAuthorsTitlesSubjectsType

    My Account

    LoginRegister

    Statistics

    View Usage Statistics

    Amref International University. All rights reserved | Copyright © 2021 
    Contact Us | Send Feedback