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
  More +
• 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
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• 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
• Download URL:
  https://stacks.cdc.gov/view/cdc/40061/cdc_40061_DS1.pdf
• File Type:
  [PDF - 395.10 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:43f4624c8768925c2929792f8f37263d3af9d4e954aae9022aa960bb21da5f3f