title: Screening for urinary tract infections in a gynaecological setting: validity and cost-effectiveness of reagent strips.
abstract: This study aims to test the validity and cost-effectiveness of reagent-strip analysis compared with microbiological laboratory testing for mass screening of urine for urinary tract infections in a gynaecological setting. Over a six-month period, urine samples from a convenient group of 228 women presenting in a gynaecological ward of an NHS Trust hospital were tested using Ames 8SG reagent strips to detect leucocyte esterase and nitrite. Total bacterial counts were also carried out; urine culture was recorded as positive if there was > 10(5) organisms/mL. Validity of the dipstick tests was measured, using four criteria (sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV]), against the results of laboratory analysis. The combined use of the leucocyte esterase and nitrite tests produced results as follows: sensitivity, 96.4%; specificity, 88.5%; PPV, 54%; and NPV, 99.4%. Cost-effectiveness for visible costs was calculated as 48.6% for the 12.3% rate of infection in this study. The use of reagent strips in a mass-screening programme in a gynaecological setting proved both valid and cost-effective.
authors.affiliation: Leicester Royal Infirmary NHS Trust, UK.
authors.forename: A
authors.initials: A
authors.lastname: Preston
authors.forename: T
authors.initials: T
authors.lastname: O'Donnell
authors.forename: C A
authors.initials: CA
authors.lastname: Phillips
mesh_terms: D003362:Cost-Benefit Analysis; D004739:England; D005260:Female; D006176:Gynecology / Q000379:methods; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D011934:Reagent Strips; D014552:Urinary Tract Infections / Q000175:diagnosis*
chemical_list: D011934:Reagent Strips