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    Peer Reviewed

    Evaluation of WHO diagnostic algorithm for reproductive tract infections among married women.

    Ranjan R; Sharma AK; Mehta G

    Indian Journal of Community Medicine. 2003 Apr-Jun; 28(2):[5] p..

    Research question: What is the sensitivity and specificity of WHO s syndromic approach in diagnosing Reproductive Tract Infections (RTIs)? Objective: To test the validity of WHO diagnostic algorithm in diagnosing RTIs among married women. Study design: Cross-sectional study. Setting: Primary Health Centre, Palam, New Delhi. Participants: Married women attending antenatal and gynae clinics. Sample size: 300 married women. Statistical analysis: Proportions. Results: The prevalence of RTIs in married women was 37.0% by syndromic approach based on symptoms, 51.7% by clinical examination and 36.7% by microbiological laboratory investigations. The sensitivity and specificity of syndromic approach to diagnose any RTI was 53.6% and 72.6% respectively while clinical examination had 68.2% sensitivity and 60.5% specificity. Overall clinical examination had relatively high sensitivity but low specificity. For trichomoniasis and bacterial vaginosis the clinical examination had low sensitivity but a high specificity. Conclusions: WHO syndromic approach based on symptoms had a low sensitivity in diagnosing RTIs among women. Sensitivity increased when clinical examination was used for the diagnosis of these infections. In the absence of microbiological laboratory facilities, syndromic approach should be supplemented with clinical examination for diagnosing RTIs in women to avoid over-treatment of women. (author's)
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