title: Direct questioning of genital symptoms: increasing opportunities for identifying and treating sexually transmitted infections in primary health-care settings.
abstract: We investigated the validity of self-reporting of genital symptoms amongst rural women attending primary health care clinics in rural KwaZulu-Natal. Random samples of 226 women were interviewed to measure self-reporting (unprompted), prompted and pelvic examination findings of genital symptoms. Against the presence of any STI self-reporting (unprompted) of symptoms had a sensitivity of 46.1%, specificity of 64.7%, positive predictive value (PPV) of 80.0% and negative predictive value (NPV) of 28.0% compared to prompted symptoms which had a sensitivity of 78.5%, specificity of 52.9%, PPV of 80.4% and NPV of 50.0%. The agreement between self-reporting (unprompted) and prompted symptoms was 0.54 (Kappa statistic). Our results suggest that in rural areas, by prompting women with a simple set of questions, the identification and treatment of STIs in this population would be enhanced, leading to better reproductive health outcomes including reduction of risk of infection with HIV.
authors.affiliation: Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. kharsany@ukzn.ac.za
authors.forename: Ayesha B M
authors.initials: AB
authors.lastname: Kharsany
authors.forename: May
authors.initials: M
authors.lastname: Mashego
authors.forename: Mukeliswe
authors.initials: M
authors.lastname: Mdlotshwa
authors.forename: Janet
authors.initials: J
authors.lastname: Frohlich
authors.forename: Quarraisha Abdool
authors.initials: QA
authors.lastname: Karim
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010808:Physical Examination; D011320:Primary Health Care / Q000458:organization & administration*; D012424:Rural Population; D012680:Sensitivity and Specificity; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000517:prevention & control