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  1. 1
    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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  2. 2

    Primary and secondary infertility in Tanzania.

    Larsen U

    Journal of Health and Population in Developing Countries. 2003 Jul 2; [15] p..

    The trend and predictors of infertility are not well known in sub-Saharan Africa. A nationally representative Demographic and Health Survey (TDHS) was conducted in Tanzania in 1991/92, 1996 and 1999, enabling a trend study of infertility. Logistic regression was used to determine the predictors of infertility. The prevalence of primary infertility was about 2.5%, and secondary infertility was about 18%. There was no change between the 1991/92, 1996 and 1999 TDHS. The risk of primary infertility was higher in the Dar es Salaam and Coast regions than in other regions and secondary infertility was higher in the Dar es Salaam region. The Dar es Salaam and Coast regions are known for also having elevated levels of HIV/AIDS. Because sexual practices and sexually transmitted diseases are strong predictors of pathological infertility and HIV infection in Africa, we recommend that concerted efforts be made to integrate the prevention of new incidences of infertility with the HIV/AIDS campaigns. (author's)
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