Zribi M, Mansour K Ben, Abid F, Masmoudi A, Fendri C
Microbiology Laboratory, Hospital La Rabta, rue jabbari 1007, Tunis, Tunisia.
Int J STD AIDS. 2008 Feb;19(2):112-4. doi: 10.1258/ijsa.2007.007140.
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 sensitivity of 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.
世界卫生组织强调采用性传播感染综合征管理的综合初级保健方法。我们研究的目的是评估突尼斯拉卜塔医院对女性性传播疾病综合征管理的护理质量。已制定了针对以下病症的算法：淋病奈瑟菌或衣原体引起的宫颈炎（算法3a）、阴道毛滴虫或沙眼衣原体引起的阴道炎（算法3b）以及念珠菌引起的阴道炎（算法3c）。2003年2月至2004年4月期间，共有116名女性参与了该研究。每种细菌的患病率分别为：衣原体（10%）、淋病奈瑟菌（1%）、梅毒螺旋体（1%）、阴道毛滴虫（5%）和念珠菌（21%）。算法“3a”的敏感性为45%，特异性为42%，阳性预测值（PPV）为11.9%。算法“3b”的敏感性为35.7%，特异性为68.9%，PPV为20.8%。算法“3c”的敏感性为12%，特异性为88%，PPV为33.3%。为提高综合征方法的敏感性，我们建议提高病史采集的质量。
