| Title | Improving the accuracy of syndromic diagnosis of genital ulcer disease in Malawi. | | Author(s) | Hoyo C, Hoffman I, Moser BK, Hobbs MM, Kazembe P, Krysiak RG, Cohen MS | | Institution | Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. hoyo0001@mc.duke.edu | | Source | Sex Transm Dis 2005 Apr; 32(4):231-7. | | MeSH | Adult
Algorithms
Chancroid
Cross-Sectional Studies
Enzyme-Linked Immunosorbent Assay
Female
Haemophilus ducreyi
Herpes Simplex
Humans
Malawi
Male
Polymerase Chain Reaction
Predictive Value of Tests
Prevalence
ROC Curve
Research Support, U.S. Gov't, P.H.S.
Sexually Transmitted Diseases
Simplexvirus
Syphilis
Treponema pallidum
| | Abstract | OBJECTIVES/
GOAL: Most resource-poor settings rely on syndromic criteria to diagnose genital ulcer disease (GUD). However, the etiologic pathogens of GUD vary temporally and geographically, and current criteria may not reflect changes in the prevalence of specific pathogens. STUDY: In 1999, we estimated the prevalence of Treponema pallidum (Tp), herpes simplex virus (HSV), and Haemophilus ducreyi (Hd) in Malawi. We then used regression coefficients of independent correlates of HSV and Hd to develop weighted diagnostic algorithms, in which weights were beta-coefficients corresponding to each factor.
RESULTS: Overall, a decrease in the proportion of sexually transmitted disease attributable to GUD was noted in 7 years. Thirty-five percent were attributable to HSV, 30% to H. ducreyi, and 4% to T. pallidum. Areas under the receiver operating characteristic curves for weighted and unweighted HSV diagnostic algorithms were 67.6% and 66.5%, respectively. There was no significant difference in the explanatory performance of the weighted and unweighted algorithms.
CONCLUSIONS: Unweighted algorithms can therefore be used to improve diagnostic accuracy of GUD. | | Language | eng | | Pub Type(s) | Evaluation Studies
Journal Article
| | PubMed ID | 15788921 |
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