Prevalence of reproductive tract infections and the predictive value of girls’ symptom-based reporting: findings from a cross-sectional survey in rural western Kenya

Details

• Alternative Title:
  Sex Transm Infect
• Personal Author:
  Kerubo, Emily ; Laserson, Kayla F ; Otecko, Newton ; Odhiambo, Collins ; Mason, Linda ; Nyothach, Elizabeth ; Oruko, Kelvin O ; Bauman, Ashley ; Vulule, John ; Zeh, Clement ; Phillips-Howard, Penelope A
• Description:
  Objectives
  
  Reproductive tract infections (RTIs), including sexually acquired, among adolescent girls is a public health concern, but few studies have measured prevalence in low-middle-income countries. The objective of this study was to examine prevalence in rural schoolgirls in Kenya against their reported symptoms.
  
  Methods
  
  In 2013, a survey was conducted in 542 adolescent schoolgirls aged 14–17 years who were enrolled in a menstrual feasibility study. Vaginal self-swabbing was conducted after girls were interviewed face-to-face by trained nurses on symptoms. The prevalence of girls with symptoms and laboratory-confirmed infections, and the sensitivity, specificity, positive and negative predictive values of symptoms compared with laboratory results, were calculated.
  
  Results
  
  Of 515 girls agreeing to self-swab, 510 answered symptom questions. A quarter (24%) reported one or more symptoms; most commonly vaginal discharge (11%), pain (9%) or itching (4%). Laboratory tests confirmed 28% of girls had one or more RTI. Prevalence rose with age; among girls aged 16–17 years, 33% had infections. Bacterial vaginosis was the most common (18%), followed by Candida albicans (9%), Chlamydia trachomatis (3%), Trichomonas vaginalis (3%) and Neisseria gonorrhoeae (1%). Reported symptoms had a low sensitivity and positive predictive value. Three-quarters of girls with bacterial vaginosis and C. albicans, and 50% with T. vaginalis were asymptomatic.
  
  Conclusions
  
  There is a high prevalence of adolescent schoolgirls with RTI in rural Kenya. Public efforts are required to identify and treat infections among girls to reduce longer-term sequelae but poor reliability of symptom reporting minimises utility of symptom-based diagnosis in this population.
  
  Trial registration number
  
  ISRCTN17486946.
  
  
• Subjects:
  Adolescent Chlamydia Infections Cross-Sectional Studies Feasibility Studies Female Gonorrhea Health Knowledge, Attitudes, Practice Humans Prevalence Reproducibility Of Results Reproductive Tract Infections Rural Health Rural Population Sexual Behavior Sexually Transmitted Diseases Trichomonas Vaginitis Vaginal Smears Vaginosis, Bacterial Women's Health

  More +
• Source:
  Sex Transm Infect. 2016; 92(4):251-256.
• Pubmed ID:
  26819339
• Pubmed Central ID:
  PMC4893088
• Document Type:
  Journal Article
• Place as Subject:
  Kenya
• Volume:
  92
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:43f4624c8768925c2929792f8f37263d3af9d4e954aae9022aa960bb21da5f3f
• Download URL:
  https://stacks.cdc.gov/view/cdc/40061/cdc_40061_DS1.pdf
• File Type:
  [PDF - 395.10 KB ]