Reproductive-tract infections in women in low-income, low-prevalence situations: assessment of syndromic management in Matlab, Bangladesh

摘要: Summary Background In the control of reproductive-tract infections, including sexually transmitted infections (STIs), in low-income and middle-income countries, WHO recommends syndromic management for individuals with symptoms. This intervention was initially developed areas where prevalence such is high. We investigated clinical effectiveness cost this approach among a group women low infection. Methods During 5-month period, we all complaining abnormal vaginal discharge seeking care at maternal child health/family-planning centres Matlab, Bangladesh, presence laboratory-diagnosed STIs. Syndromic diagnoses made by trained health-care workers were compared laboratory diagnosis then calculated costs treating means recommended algorithm an adapted incorporating use speculum simple diagnostic tests. Findings The endogenous 320 seen 30%. Cervical (Neisseria gonorrhoeae Chlamydia trachomatis) found only three women. had high sensitivity (100%) but specificity (zero bacterial vaginosis, candida, Trichomonas vaginalis). speculum-based (between zero 59%) higher (79–97%). Between 36% 87% would have been spent on uninfected Interpretation rate overtreatment population studied carries both financial social costs- latter potentially exposing misdiagnosed as having STI to threats domestic disruption or even violence. make recommendations programmes income.