Marginal validity of syndromic management for reproductive tract infections among pregnant women in Jamaica

Academic Article

Abstract

  • We assessed the validity of a syndromic case management approach for reproductive tract infections (RTIs) among 371 pregnant women attending antenatal care facilities in Kingston, Jamaica, using an algorithm previously validated in high-risk Jamaican women. For our antenatal attenders, the algorithm had low sensitivities for all RTIs (66.7% for cervicitis, 35.4% for trichomoniasis, 11.1% for bacterial vaginosis (BV) and 24% for candidiasis). Specificities for BV (88.9%) and candidiasis (81.1%) were higher than for cervicitis (62.8%) and trichomoniasis (68.5%). The positive predictive values were lower than 36% for all diagnoses, especially BV (6.9%). Syndromic management of RTIs in pregnant women was problematic using a clinical algorithm that had worked well for high-risk women. Syndromic management for RTIs in Jamaican antenatal clinics is only a temporary solution until more simple and affordable diagnostic tests for RTIs are developed and/or until laboratory support and clinical care can be upgraded at antenatal clinics.
  • Published In

    Digital Object Identifier (doi)

    Author List

  • Hylton-Kong T; Brathwaite AR; Del Rosario GR; Kristensen S; Kamara P; Jolly PE; Hook EW; Figueroa JP; Vermund SH
  • Start Page

  • 371
  • End Page

  • 375
  • Volume

  • 15
  • Issue

  • 6