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Evaluation of clinical and laboratory markers of cervicitis in STD patients in Malawi.

Dallabetta G, Miotti P, Liomba G, Chiphangwi J, Wangel AM, Nyirenda M, Saah A, Meyers L, Graham N; International Conference on AIDS.

Int Conf AIDS. 1992 Jul 19-24; 8: Tu29 (abstract no. TuB 0510).

Johns Hopkins University, Baltimore.

OBJECTIVE: To establish the diagnostic utility of cervical friability (CX FRIAB) and cervical discharge (CX DIS) on physical exam and leukocyte esterase dipstick (LED) for cervicitis caused by N. gonorrhoeae (GC) or C. trachomatis (CT) in an STD clinic. METHODS: 505 consecutive women presenting to an STD clinic had a pelvic exam; women were assessed for presence of endo-cervical discharge (after removal of ectocervical discharge), for cervical friability (bleeding with the first endocervical swab), and for genital ulcers (GUD). Cervical samples were obtained for GC culture, CT ELISA and LED, vaginal fluid for wet mounts, and blood for syphilis serology. RESULTS: The prevalence of STD in these women was: GC 14%, trichomonas 26%, CT 5% (175 women only), syphilis 25%, and GUD 6%. The sensitivity (SENS), specificity (SPEC) and positive predictive value (PPV) of markers for cervicitis was as follows: TABULAR DATA, SEE ABSTRACT VOLUME. The performance characteristics of LED remained unchanged when stratified by presence or absence of inflammatory vaginitis (trichomonas or yeast on wet mount) CONCLUSION: LED was only able to identify about one half the women with GC or CT, but had a much higher sensitivity than the classic clinical indicators of cervicitis. LED may be useful for detection of cervicitis in peripheral settings where other diagnostic tests are unavailable. LED should be evaluated in an algorithmic approach to the diagnosis of lower genital tract infections in women.

Publication Types:
  • Meeting Abstracts
Keywords:
  • Ambulatory Care Facilities
  • Evaluation Studies
  • Female
  • Gonorrhea
  • Humans
  • Malawi
  • Physical Examination
  • Prevalence
  • Sensitivity and Specificity
  • Trichomonas Infections
  • Uterine Cervical Diseases
  • Uterine Cervicitis
  • Vaginitis
  • methods
Other ID:
  • 92400173
UI: 102197886

From Meeting Abstracts




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