Chlamydia and gonorrhoea in pregnant Batswana women: time to discard the syndromic approach?
2007

Chlamydia and Gonorrhoea in Pregnant Women in Botswana

Sample size: 703 publication 10 minutes Evidence: moderate

Author Information

Author(s): Romoren Maria, Sundby Johanne, Velauthapillai Manonmany, Rahman Mafizur, Klouman Elise, Hjortdahl Per

Primary Institution: Institute of General Practice and Community Medicine, Faculty of Medicine, University of Oslo

Hypothesis

Can risk scores improve the diagnostic accuracy of cervical infections in pregnant women using the syndromic approach?

Conclusion

The syndromic approach is unsuitable for diagnosing cervical infections in antenatal care attendees in Botswana, and none of the evaluated risk scores can replace this management.

Supporting Evidence

  • The prevalence of chlamydia was 8%, and gonorrhoea was found in 3% of the attendees.
  • Symptoms and signs of vaginal discharge did not predict cervical infection.
  • A risk score based on sociodemographic factors had similar likelihood ratios to those incorporating clinical signs.
  • All evaluated risk scores were of limited value in diagnosing chlamydia and gonorrhoea.

Takeaway

This study looked at pregnant women in Botswana and found that the usual way of diagnosing infections isn't working well, so we need better tests.

Methodology

A cross-sectional study where 703 antenatal care attendees were interviewed and examined for cervical infections.

Potential Biases

Potential bias due to reliance on self-reported symptoms and the syndromic approach.

Limitations

The study relied on a syndromic approach which is known to be inadequate for accurate diagnosis.

Participant Demographics

Pregnant women attending antenatal care in Gaborone, Botswana.

Statistical Information

P-Value

0.000

Confidence Interval

95% CI: 13 to 32

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1471-2334-7-27

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