Skip to main content
Genitourinary Medicine logoLink to Genitourinary Medicine
. 1996 Jun;72(3):182–186. doi: 10.1136/sti.72.3.182

Clinical algorithms for the screening of Chlamydia trachomatis in Turkish women.

C Ronsmans 1, A Bulut 1, N Yolsal 1, A Agaçfidan 1, V Filippi 1
PMCID: PMC1195647  PMID: 8707320

Abstract

OBJECTIVE: To test the diagnostic validity of clinical algorithms for the detection of Chlamydia trachomatis in an urban population of married women in Turkey. DESIGN: Cross-sectional population-based survey. SUBJECTS: A systematic sample of 867 women who reported the use of contraceptive methods. MAIN OUTCOME MEASURES: Sensitivity, specificity and positive predictive value of clinical algorithms for the diagnosis of C trachomatis. RESULTS: C trachomatis was diagnosed in 4.89% of the women. The WHO algorithm for use in settings where no vaginal examination could be performed had a sensitivity of 9% and a specificity of 96%. The corresponding figures for the WHO algorithm incorporating the findings of a speculum examination were 47% and 56% respectively. Algorithms incorporating symptoms or signs other than those suggested by the WHO did not yield satisfactory standards of validity. CONCLUSIONS: The findings of this study do not support the widespread introduction of the use of clinical decision models for screening of women for chlamydia infection in primary health care settings such as family planning or antenatal clinics. The large number of false positive results with the use of the clinical algorithms tested in this study would cause unnecessary costs to the health system and unnecessary interventions to the women treated.

Full text

PDF
182

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Addiss D. G., Vaughn M. L., Golubjatnikov R., Pfister J., Kurtycz D. F., Davis J. P. Chlamydia trachomatis infection in women attending urban midwestern family planning and community health clinics: risk factors, selective screening, and evaluation of non-culture techniques. Sex Transm Dis. 1990 Jul-Sep;17(3):138–146. doi: 10.1097/00007435-199007000-00006. [DOI] [PubMed] [Google Scholar]
  2. Amsel R., Totten P. A., Spiegel C. A., Chen K. C., Eschenbach D., Holmes K. K. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983 Jan;74(1):14–22. doi: 10.1016/0002-9343(83)91112-9. [DOI] [PubMed] [Google Scholar]
  3. Bassiri M., Hu H. Y., Domeika M. A., Burczak J., Svensson L. O., Lee H. H., Mårdh P. A. Detection of Chlamydia trachomatis in urine specimens from women by ligase chain reaction. J Clin Microbiol. 1995 Apr;33(4):898–900. doi: 10.1128/jcm.33.4.898-900.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Brunham R. C., Paavonen J., Stevens C. E., Kiviat N., Kuo C. C., Critchlow C. W., Holmes K. K. Mucopurulent cervicitis--the ignored counterpart in women of urethritis in men. N Engl J Med. 1984 Jul 5;311(1):1–6. doi: 10.1056/NEJM198407053110101. [DOI] [PubMed] [Google Scholar]
  5. Genç M., Agaçfidan A., Yegenoglu Y., Turan O., Kuru U., Mårdh P. A. Screening for Chlamydia trachomatis and Neisseria gonorrhoeae in pregnant Turkish women. Eur J Clin Microbiol Infect Dis. 1993 May;12(5):395–396. doi: 10.1007/BF01964442. [DOI] [PubMed] [Google Scholar]
  6. Handsfield H. H., Jasman L. L., Roberts P. L., Hanson V. W., Kothenbeutel R. L., Stamm W. E. Criteria for selective screening for Chlamydia trachomatis infection in women attending family planning clinics. JAMA. 1986 Apr 4;255(13):1730–1734. [PubMed] [Google Scholar]
  7. Johnson B. A., Poses R. M., Fortner C. A., Meier F. A., Dalton H. P. Derivation and validation of a clinical diagnostic model for chlamydial cervical infection in university women. JAMA. 1990 Dec 26;264(24):3161–3165. [PubMed] [Google Scholar]
  8. Laga M. Epidemiology and control of sexually transmitted diseases in developing countries. Sex Transm Dis. 1994 Mar-Apr;21(2 Suppl):S45–S50. [PubMed] [Google Scholar]
  9. Lee H. H., Chernesky M. A., Schachter J., Burczak J. D., Andrews W. W., Muldoon S., Leckie G., Stamm W. E. Diagnosis of Chlamydia trachomatis genitourinary infection in women by ligase chain reaction assay of urine. Lancet. 1995 Jan 28;345(8944):213–216. doi: 10.1016/s0140-6736(95)90221-x. [DOI] [PubMed] [Google Scholar]
  10. Mayaud P., Grosskurth H., Changalucha J., Todd J., West B., Gabone R., Senkoro K., Rusizoka M., Laga M., Hayes R. Risk assessment and other screening options for gonorrhoea and chlamydial infections in women attending rural Tanzanian antenatal clinics. Bull World Health Organ. 1995;73(5):621–630. [PMC free article] [PubMed] [Google Scholar]

Articles from Genitourinary Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES