Assessment of the validity of and adherence to sexually transmitted infection algorithms at a female sex worker clinic in Abidjan, Côte d'Ivoire.
BACKGROUND
Algorithms for sexually transmitted infection (STI) case management were designed in a female sex worker (FSW) clinic in Abidjan, Côte d'Ivoire, in 1993.


OBJECTIVE
The goal was to evaluate the long-term validity of the algorithms for returning clients of the clinic and to assess the adherence of the health workers to their application.


METHODS
A cross-sectional study was conducted from 1999 to 2000 among FSWs attending as returning clients.


RESULTS
The prevalences of genital infections were as follows: Neisseria gonorrhoeae and/or Chlamydia trachomatis, 8.2%; Trichomonas vaginalis, 16.7%; bacterial vaginosis, 62.3%; and Candida albicans, 6.2%. The sensitivity of the algorithms was 20% and the positive predictive value was 14% for cervical infection. The proportion of cases for which all steps of the algorithm were correctly applied was 30%.


CONCLUSIONS
Algorithms for the treatment of STIs in FSWs should be periodically reevaluated and adapted to the changing population. To maintain healthcare workers' adherence to the algorithms, supervision should be ongoing and reinforced.
Vuylsteke
Bea L
BL
Institute of Tropical Medicine, Antwerp, Belgium. bbv1@cdc.gov
Ettiègne-Traore
Viginie
V
Anoma
Camille K
CK
Bandama
Claude
C
Ghys
Peter D
PD
Maurice
Chantal E
CE
Van Dyck
Eddy
E
Wiktor
Steffan Z
SZ
Laga
Marie
M
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D019090:Case Management / Q000592:standards*; D007560:Cote d'Ivoire / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003663:Decision Trees; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires