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Diagnosis of sexually transmitted infections in female prostitutes in Dakar, Senegal

I Ndoye, S Mboup, Antoon De Schryver, E Van Dyck, J Moran, ND Samb, ML Sakho, I Thior, A Wade, DL Heymann, et al. (1998) SEXUALLY TRANSMITTED INFECTIONS. 74(suppl. 1). p.S112-S117
abstract
Objective: To study the validity and performance of a number of rapid indicators for the diagnosis of sexually transmitted infections (STIs) in female prostitutes in Dakar, Senegal; characteristics of these indicators were rapidly obtainable, easy to perform, accurate, useful at district level, and reasonable cost. Methods: An STI prevalence study in female prostitutes (n = 374) seen at the STD clinic in Dakar, Senegal was done; a history, clinical examination, simple laboratory tests, and "gold standard" microbiological tests were performed. For a number of sociodemographic data, actual or past symptoms of STI, clinical signs, and rapid laboratory tests, validity variables, performance characteristics, and likelihood ratios for detection of gonococcal or chlamydial cervical infection were determined. Results: Cervical infection (chlamydial or gonococcal) was present in 24.9% of prostitutes; 46% had trichomoniasis and 29.4% had syphilis. Young age, abnormal vaginal discharge, endocervical mucopus, a positive leucocyte esterase test on urine, and 10 or more leucocytes in Gram stained smears of vaginal, cervical, or urine samples were significantly associated with cervical STI. Some of the rapid indicators had high sensitivity, others high specificity but none had acceptable overall validity. None of the indicators had at the same time a sensitivity above 50% and a positive predictive value above twice the background prevalence of cervical infection. 10 or more leucocytes in the cervical smear had a likelihood ratio of 1.83 increasing pretest probability of 24.9% to post-test probability of 38%, the best result obtained by any of the rapid indicators. Conclusions: Rapid indicators of cervical STIs are insufficiently valid, which largely restricts their usefulness to high STI prevalence situations for instance, in prostitute populations and in STD patient management.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
STDs, infectious diseases, prostitutes, epidemiology, DISEASES, WOMEN
journal title
SEXUALLY TRANSMITTED INFECTIONS
Sex. Transm. Infect.
volume
74
issue
suppl. 1
pages
S112 - S117
Web of Science type
Article
Web of Science id
000074916700015
ISSN
1368-4973
language
English
UGent publication?
no
classification
A1
id
280412
handle
http://hdl.handle.net/1854/LU-280412
date created
2004-05-24 13:34:00
date last changed
2017-06-06 09:57:02
@article{280412,
  abstract     = {Objective: To study the validity and performance of a number of rapid indicators for the diagnosis of sexually transmitted infections (STIs) in female prostitutes in Dakar, Senegal; characteristics of these indicators were rapidly obtainable, easy to perform, accurate, useful at district level, and reasonable cost. 
Methods: An STI prevalence study in female prostitutes (n = 374) seen at the STD clinic in Dakar, Senegal was done; a history, clinical examination, simple laboratory tests, and {\textacutedbl}gold standard{\textacutedbl} microbiological tests were performed. For a number of sociodemographic data, actual or past symptoms of STI, clinical signs, and rapid laboratory tests, validity variables, performance characteristics, and likelihood ratios for detection of gonococcal or chlamydial cervical infection were determined. 
Results: Cervical infection (chlamydial or gonococcal) was present in 24.9\% of prostitutes; 46\% had trichomoniasis and 29.4\% had syphilis. Young age, abnormal vaginal discharge, endocervical mucopus, a positive leucocyte esterase test on urine, and 10 or more leucocytes in Gram stained smears of vaginal, cervical, or urine samples were significantly associated with cervical STI. Some of the rapid indicators had high sensitivity, others high specificity but none had acceptable overall validity. None of the indicators had at the same time a sensitivity above 50\% and a positive predictive value above twice the background prevalence of cervical infection. 10 or more leucocytes in the cervical smear had a likelihood ratio of 1.83 increasing pretest probability of 24.9\% to post-test probability of 38\%, the best result obtained by any of the rapid indicators. 
Conclusions: Rapid indicators of cervical STIs are insufficiently valid, which largely restricts their usefulness to high STI prevalence situations for instance, in prostitute populations and in STD patient management.},
  author       = {Ndoye, I and Mboup, S and De Schryver, Antoon and Van Dyck, E and Moran, J and Samb, ND and Sakho, ML and Thior, I and Wade, A and Heymann, DL and Meheus, A},
  issn         = {1368-4973},
  journal      = {SEXUALLY TRANSMITTED INFECTIONS},
  keyword      = {STDs,infectious diseases,prostitutes,epidemiology,DISEASES,WOMEN},
  language     = {eng},
  number       = {suppl. 1},
  pages        = {S112--S117},
  title        = {Diagnosis of sexually transmitted infections in female prostitutes in Dakar, Senegal},
  volume       = {74},
  year         = {1998},
}

Chicago
Ndoye, I, S Mboup, Antoon De Schryver, E Van Dyck, J Moran, ND Samb, ML Sakho, et al. 1998. “Diagnosis of Sexually Transmitted Infections in Female Prostitutes in Dakar, Senegal.” Sexually Transmitted Infections 74 (suppl. 1): S112–S117.
APA
Ndoye, I., Mboup, S., De Schryver, A., Van Dyck, E., Moran, J., Samb, N., Sakho, M., et al. (1998). Diagnosis of sexually transmitted infections in female prostitutes in Dakar, Senegal. SEXUALLY TRANSMITTED INFECTIONS, 74(suppl. 1), S112–S117.
Vancouver
1.
Ndoye I, Mboup S, De Schryver A, Van Dyck E, Moran J, Samb N, et al. Diagnosis of sexually transmitted infections in female prostitutes in Dakar, Senegal. SEXUALLY TRANSMITTED INFECTIONS. 1998;74(suppl. 1):S112–S117.
MLA
Ndoye, I, S Mboup, Antoon De Schryver, et al. “Diagnosis of Sexually Transmitted Infections in Female Prostitutes in Dakar, Senegal.” SEXUALLY TRANSMITTED INFECTIONS 74.suppl. 1 (1998): S112–S117. Print.