Lack of utility of risk score and gynecological examination for screening for sexually transmitted infections in sexually active adolescents.
BMC Med
; 7: 8, 2009 Mar 11.
Article
em En
| MEDLINE
| ID: mdl-19284575
ABSTRACT
BACKGROUND:
Sexually transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiânia, Brazil, and validated cervicitis diagnosis using World Health Organization/Ministry of Health risk score and gynecological examination.METHODS:
A cross-sectional community-based sample of 914 15- to 19-year-old female teenagers was randomly selected and referred to the local Family Health Program. Of these, 472 (51.6%) were sexually active and gynecological examinations were carried out for 427. Endocervical samples were collected to perform the polymerase chain reaction for C. trachomatis and N. gonorrhoeae. Performance of risk score, the presence of mucopurulent discharge, friability, ectopia and pain during cervical maneuver were compared with the presence of C. trachomatis or N. gonorrhoeae or both.RESULTS:
The prevalence of C. trachomatis and N. gonorrhoeae was 14.5% and 2.1%, respectively. The risk score had a specificity of 31.9% (95% confidence interval, 21.2 to 44.2) and a positive predictive value of 20.8% (95% confidence interval, 13.5 to 29.7). Friability was the component of the gynecological examination that presented the best performance with a sensitivity of 43.5%, specificity of 81.0%, and 30.6% of positive predictive value.CONCLUSION:
The prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Gonorreia
/
Linfogranuloma Venéreo
/
Chlamydia trachomatis
/
Programas de Rastreamento
/
Pesquisa sobre Serviços de Saúde
/
Neisseria gonorrhoeae
Idioma:
En
Ano de publicação:
2009
Tipo de documento:
Article