Nakku-joloba E, Kambugu F, Neuhauser D, Borawski E, Whalen C; International Conference on AIDS.

Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. ThPeC7587.

Department of Epidemiology and Biostatistics Case Western Reserve University School of Medicine, Mulago Hospital STD Clinic, Cleveland,OH, United States

BACKGROUND: Management of sexually transmitted diseases (STD) in resource poor countries is based on syndromic approach. However, the positive predictive value of syndromic diagnosis depends on local prevalence. In Uganda, data on rural STD prevalence is limited. The objective of this study was to determine prevalence of STDs in rural STD clinic attendees using molecular diagnostics. METHODS: A cross-sectional study was conducted at 2 rural clinics in Uganda, from June to August 2001. A questionnaire seeking demographic and risk factors for STDs was administered. A syndromic diagnosis, based on national guidelines, was made. Samples (vaginal swabs, urine) were analyzed by PCR for gonococcal, chlamydia, chancroid, herpes, syphilis and trichomonas infection. HIV diagnosis was by ELISA, and syphilis by RPR. RESULTS: A total of 394 patients mean age 28yrs (SD 9.3), females 306 (77%) were seen. Prevalence of Lower abdominal pain was 97 (25%), Abnormal vaginal discharge173 (44%), Urethral discharge syndrome 23 (6%), Genital ulcers 44 (11%). Prevalence of gonorrhea was 30 (8%), trichomonas 35 (9.0%), chlamydia 5 (1%). Fifty-eight patients (15%) tested HIV positive and 10 (3%) RPR positive. Of 25 people tested for herpes, 8 were positive (30%). The sensitivity, specificity and Positive Predictive value (PPV) of vaginal discharge or lower abdominal pain diagnosis, compared to PCR diagnosis for gonorrhea, trichomonas or chlamydia was 80%, 24% and 21% respectively. In men sensitivity, specificity and PPV for urethral discharge syndrome compared to PCR for gonorrhea or chlamydia was 91%, 83% and 43% respectively. CONCLUSIONS: The sensitivity and predictive value of syndromic diagnosis is limited. Molecular diagnostics technology should be transferred to developing countries.

Publication Types:

• Meeting Abstracts

Keywords:

• Ambulatory Care Facilities
• Chancroid
• Chlamydia Infections
• Cross-Sectional Studies
• Female
• Gonorrhea
• HIV Seropositivity
• Humans
• Male
• Prevalence
• Risk Factors
• Sensitivity and Specificity
• Sexually Transmitted Diseases
• Syphilis
• Trichomonas Infections
• Uganda
• Urethral Diseases
• Vaginal Discharge
• epidemiology

Other ID:

• GWAIDS0018125

UI: 102255623

From Meeting Abstracts