ARSH 9: Lower reproductive tract infections among unmarried girls (15-24 y) - a clinic based validation study.
OBJECTIVE
To compare clinical and laboratory diagnosis of lower reproductive tract infections (RTIs) in a clinic setting, among unmarried adolescents and young adults between 15 and 24 y and to validate clinical diagnosis of lower RTIs against the microbiological diagnosis as gold standard.


METHODS
A structured questionnaire was administered among the participants to assess symptoms of lower reproductive tract infections and associated known risk factors. A qualified gynecologist conducted the visual inspection of the external genitalia for any clinical evidence of lower RTIs and took cotton tipped swab from the vulva (outside the hymen) for laboratory examination. The swabs were examined by a qualified Laboratory Technician for evidence of candidiasis, and bacterial vaginosis.


RESULTS
Out of the total of 427 unmarried girls enrolled in the study, 344 (80.6%) belonged to the age group 15-19 y and 83 (19.4%) to 20-24 y. The results of this clinic based study validating clinical diagnosis against laboratory diagnosis as gold standard have shown 62.69% sensitivity, 97.78% specificity, 0.76 positive predictive value, 0.96 negative predictive value and 92.27 overall accuracy.


CONCLUSIONS
The results of this clinic based study on unmarried adolescent lower reproductive tract infections validating clinical diagnosis against laboratory diagnosis as gold standard have shown a high 0.96 negative predictive value, suggesting that external genital examination is enough to rule out lower reproductive tract infections among unmarried adolescents.
Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, 695 011, Kerala, South India, cdcmkc@gmail.com.
M K C
MK
Nair
B
B
Thiruvenkiteswari
M L
ML
Leena
C
C
Nirmala
M
M
Manjula
Babu
B
George
Paul Swamidhas Sudhakar
PS
Russell
D000293:Adolescent; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D005260:Female; D006801:Humans; D017533:Marital Status; D010808:Physical Examination; D060737:Reproductive Tract Infections / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D016585:Vaginosis, Bacterial / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D055815:Young Adult