Table 5.
Accuracy of light microscopic criteria and syndromic approach to diagnose urogenital gonorrhoea in 360 females in Jakarta and Yogyakarta, Indonesia (January–December 2014)
| Diagnostic criterion | N | Diagnosis outcome | Sensitivity | Specificity | PPV | NPV | Kappa± SE |
|||||
| Ng-PCR positive n=104 (28.9%) |
Ng-PCR negative n=256 (71.1%) |
% (95% CI) | p | % (95% CI) | p | % (95% CI) | % (95% CI) | |||||
| Met criterion | Did not meet criterion | Met criterion | Did not meet criterion | |||||||||
| 1. PMNL | ||||||||||||
| Overall | 360 | 33 | 71 | 82 | 174 | 31.7 (23.0 to 41.6) | – | 68.0 (61.9 to 73.6) | – | 28.7 (20.7– to 7.9) | 71.0 (64.9 to 76.6) | 0.00±0.05 |
| Service settings | 0.23 | 0.53 | ||||||||||
| Clinic based | 28 | 2 | 10 | 4 | 12 | 16.7 (2.1 to 48.4) | 75.0 (47.6 to 92.7) | 33.3 (4.3 to 77.7) | 54.6 (32.2 to 75.6) | −0.09±0.17 | ||
| Outreach | 332 | 31 | 61 | 78 | 162 | 33.7 (24.2 to 44.3) | 67.5 (61.2 to 73.4 | 28.4 (20.2 to 37.9) | 72.7 (66.3 to 78.4) | 0.01±0.05 | ||
| Urogenital symptoms* | 0.004 | <0.001 | ||||||||||
| Absent | 259 | 15 | 53 | 48 | 143 | 22.1 (12.9 to 33.8) | 74.9 (68.1 to 80.9) | 23.8 (14.0 to 36.2) | 73.0 (66.2 to 79.0) | −0.03±0.06 | ||
| Present | 101 | 18 | 18 | 34 | 31 | 50.0 (32.9 to 67.1) | 47.7 (35.2 to 60.5) | 34.6 (22.0 to 49.1) | 63.3 (48.3 to 76.6) | −0.02±0.09 | ||
| 2. IGND | ||||||||||||
| Overall | 360 | 33 | 71 | 39 | 217 | 31.7 (23.0 to 41.6) | – | 84.8 (79.8 to 88.9) | – | 45.8 (34.0 to 58.0) | 75.4 (70.0 to 80.2) | 0.18±0.05 |
| Service settings | 0.23 | 0.75 | ||||||||||
| Clinic based | 28 | 2 | 10 | 2 | 14 | 16.7 (2.1 to 48.4) | 87.5 (61.7 to 98.5) | 50.0 (6.8 to 93.2) | 58.3 (36.6 to 77.9) | 0.05±0.15 | ||
| Outreach | 332 | 31 | 61 | 37 | 203 | 33.7 (24.2 to 44.3) | 84.6 (79.4 to 88.9) | 45.6 (33.5 to 58.1) | 76.9 (71.3 to 81.8) | 0.20±0.05 | ||
| Urogenital symptoms* | 0.004 | 0.005 | ||||||||||
| Absent | 259 | 15 | 53 | 22 | 169 | 22.1 (12.9 to 33.8) | 88.5 (83.1 to 92.6) | 40.5 (24.8 to 57.9) | 76.1 (70.0 to 81.6) | 0.13±0.06 | ||
| Present | 101 | 18 | 18 | 17 | 48 | 50.0 (32.9 to 67.1) | 73.9 (61.5 to 84.0) | 51.4 (34.0 to 68.6) | 72.7 (60.4 to 83.0) | 0.24±0.10 | ||
| 3. Urogenital symptoms* | ||||||||||||
| Overall | 360 | 36 | 68 | 65 | 191 | 34.6 (25.6 to 44.6) | – | 74.6 (68.8 to 79.8) | – | 35.6 (26.4 to 45.8) | 73.8 (67.9 to 79.0) | 0.09±0.05 |
| Service settings | <0.001 | 0.08 | ||||||||||
| Clinic based | 28 | 10 | 2 | 7 | 9 | 83.3 (51.6 to 97.9) | 56.3 (29.9 to 80.3) | 58.8 (32.9 to 81.6) | 81.8 (48.2 to 97.7) | 0.38±0.18 | ||
| Outreach | 332 | 26 | 66 | 58 | 182 | 28.3 (19.4 to 38.6) | 75.8 (69.9 to 81.1) | 31.0 (21.3 to 42.0) | 73.4 (67.4 to 78.8) | 0.04±0.05 | ||
*Reported genital discharge and/or genital pain at the day of consultation.
IGND, intracellular Gram-negative diplococcus; Ng-PCR, Neisseria gonorrhoeae PCR; NPV, negative predictive value; p, p values calculated using χ2 test; PMNL, polymorphonuclear leucocytes; PPV, positive predictive value.