The demographic and clinical profiles of women presenting with vaginal discharge syndrome at primary care facilities in South Africa: Associations with age and implications for management
| Autor: | Lindy Gumede, Ranmini Kularatne, Tendesayi Kufa, F Radebe, D V Maseko |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Vaginal discharge
medicine.medical_specialty HIV Positivity lcsh:Medicine medicine.disease_cause Asymptomatic 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Urethritis Sex organ 030212 general & internal medicine lcsh:R5-920 030505 public health business.industry lcsh:R General Medicine medicine.disease Etiology medicine.symptom Bacterial vaginosis lcsh:Medicine (General) 0305 other medical science Chlamydia trachomatis business |
| Zdroj: | SAMJ: South African Medical Journal, Volume: 108, Issue: 10, Pages: 876-880, Published: OCT 2018 South African Medical Journal; Vol 108, No 10 (2018); 876-880 South African Medical Journal, Vol 108, Iss 10, Pp 876-880 (2018) |
| ISSN: | 2078-5135 |
| Popis: | Background. Current South African guidelines for the management of vaginal discharge syndrome (VDS) do not recommend treatment for sexually transmitted infection (STI) pathogens for women aged ≥35 years whose partners do not have male urethritis syndrome. The guideline assumes that older women are unlikely to have an STI and that their partners do not have asymptomatic infections. Objectives. To describe the demographic, behavioural and clinical characteristics of women with VDS, comparing older women (≥35 years) with younger women, and to determine the performance of age alone as a criterion for predicting the presence of STI. Methods. This was a cross-sectional study at seven primary healthcare centres taking part in the aetiological surveillance of STIs between January 2015 and December 2016. Eligible women presenting with VDS were enrolled and completed a nurse-administered questionnaire. Genital swabs and blood specimens were collected for laboratory testing. Data were entered into surveillance-specific databases and exported into Stata 14 for analysis. Descriptive statistics were used to compare demographic and clinical profiles of older with younger women. A receiver operator curve (ROC) was used to determine the age cut-off that would best differentiate between women who had infection with STI pathogens and those without. Results. Of 757 women enrolled, 157 (20.7%) were aged ≥35 years. HIV positivity was 46.6%, and higher in older than younger women (54.9% v. 44.5%; p =0.02). Of those enrolled, 283 (37.4%) had bacterial vaginosis (BV) and/or Candida infection only, 232 (30.7%) had BV or Candida with STI pathogens detected, 98 (13%) were infected with STI pathogens only, and 144 (19.0%) did not have any detectable STI or non-STI causes. Although older women were less likely than younger women to have Neisseria gonorrhoeae , Chlamydia trachomatis or Mycoplasma genitalium infection (23.6% v. 38.2%; p |
| Databáze: | OpenAIRE |
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