Prevalence of reproductive tract infections and the predictive value of girls’ symptom-based reporting: findings from a cross-sectional survey in rural western Kenya
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Authors
Kerubo, Emily
Laserson, Kayla F.
Otecko, Newton
Odhiambo, Collins
Mason, Linda
Nyothach, Elizabeth
Oruko, Kelvin O.
Bauman, Ashley
Vulule, John
Zeh, Clement
Issue Date
2016-01-27
Type
Article
Language
en_US
Keywords
Adolescent , Africa , Diagnosis , Reproductive Health , Sexual Health
Alternative Title
Abstract
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.
Description
Citation
Kerubo, E., Laserson, K. F., Otecko, N., Odhiambo, C., Mason, L., Nyothach, E., Oruko, K. O., Bauman, A., Vulule, J., Zeh, C., & Phillips-Howard, P. A. (2016). Prevalence of reproductive tract infections and the predictive value of girls' symptom-based reporting: findings from a cross-sectional survey in rural western Kenya. Sexually transmitted infections, 92(4), 251–256. https://doi.org/10.1136/sextrans-2015-052371
Publisher
Sexually Transmitted Infections