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International Journal of STD & AIDS

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Int J STD AIDS 2008;19:112-114
doi:10.1258/ijsa.2007.007140
© 2008 Royal Society of Medicine Press

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ORIGINAL RESEARCH ARTICLES

Syndromic approach to sexually transmitted infections in Tunisian women: bacteriological validation

M Zribi PhD , K Ben Mansour PhD, F Abid, A Masmoudi and C Fendri

Microbiology Laboratory, Hospital La Rabta, rue jabbari 1007, Tunis, Tunisia

Correspondence to: Dr Meriam Zribi Email: m.zribi{at}tunet.tn

The World Health Organization emphasizes an integrated primary care approach using syndromic management of sexually transmitted infections. The objective of our study was to evaluate the quality of care of the syndromic management of sexually transmitted disease in women in Rabta hospital in Tunisia. Algorithms have been developed for: cervicitis due to Neisseria gonorrhoeae or Chlamydia (algorithm 3a), vaginitis due to Trichomonas vaginalis or Chlamydia trachomatis (algorithm 3b) and vaginitis due to Candida (algorithm 3c). A total of 116 women were enrolled in the study during February 2003 to April 2004.

The prevalence of each bacterium was Chlamydia (10%), N. gonorrhoeae (1%), Treponema pallidum (1%), T. vaginalis (5%) and Candida (21%). Algorithm ‘3a’ had a sensitivity of 45%, a specificity of 42% and positive predictive value (PPV) of 11.9%. Algorithm ‘3b’ had a sensitivity of 35.7%, a specificity of 68.9% and PPV of 20.8%. Algorithm ‘3c’ had a sensitivityof 12%, a specificity of 88% and PPV of 33.3%. To improve the sensitivity of the syndromic approach, we suggest improving the quality of history taking.

Key Words: sexually transmitted infections • syndromic approach • validation


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