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Kerubo, Emily, Laserson, Kayla F, Otecko, Newton, Odhiambo, Collins, Mason, Linda, Nyothach, Elizabeth, Oruko, Kelvin O, Bauman, Ashley, Vulule, John, Zeh, Clement and Phillips-Howard, Penelope 
ORCID: https://orcid.org/0000-0003-1018-116X
(2016)
'Prevalence of reproductive tract infections and the predictive value of girls’ symptom-based reporting: findings from a cross-sectional survey in rural western Kenya'. Sexually Transmitted Infections, Vol 92, Issue 4.
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Abstract
Objectives
Reproductive tract infections (RTIs), including sexually acquired, among adolescent girls is a public health concern, but few studies have measured prevalence in low-middle-income countries. The objective of this study was to examine prevalence in rural schoolgirls in Kenya against their reported symptoms.
Methods
In 2013, a survey was conducted in 542 adolescent schoolgirls aged 14–17 years who were enrolled in a menstrual feasibility study. Vaginal self-swabbing was conducted after girls were interviewed face-to-face by trained nurses on symptoms. The prevalence of girls with symptoms and laboratory-confirmed infections, and the sensitivity, specificity, positive and negative predictive values of symptoms compared with laboratory results, were calculated.
Results
Of 515 girls agreeing to self-swab, 510 answered symptom questions. A quarter (24%) reported one or more symptoms; most commonly vaginal discharge (11%), pain (9%) or itching (4%). Laboratory tests confirmed 28% of girls had one or more RTI. Prevalence rose with age; among girls aged 16–17 years, 33% had infections. Bacterial vaginosis was the most common (18%), followed by Candida albicans (9%), Chlamydia trachomatis (3%), Trichomonas vaginalis (3%) and Neisseria gonorrhoeae (1%). Reported symptoms had a low sensitivity and positive predictive value. Three-quarters of girls with bacterial vaginosis and C. albicans, and 50% with T. vaginalis were asymptomatic.
Conclusions
There is a high prevalence of adolescent schoolgirls with RTI in rural Kenya. Public efforts are required to identify and treat infections among girls to reduce longer-term sequelae but poor reliability of symptom reporting minimises utility of symptom-based diagnosis in this population.
Trial registration number: ISRCTN17486946.
| Item Type: | Article |
|---|---|
| Subjects: | W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 85 Patients. Attitude and compliance WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WP Gynecology > Anatomy. Diseases. Injuries > WP 140 Diseases (General) WS Pediatrics > By Age Groups > WS 460 Adolescence (General) |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1136/sextrans-2015-052371 |
| Depositing User: | Jessica Jones |
| Date Deposited: | 15 Mar 2016 14:45 |
| Last Modified: | 13 Sep 2019 14:16 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/5771 |
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