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Simple algorithms for the management of genital ulcers: evaluation in a primary health care centre in Kigali, Rwanda.
Bull World Health Organ. 1995; 73(6):761-7.BW

Abstract

A cross-sectional study was conducted among 395 patients presenting with genital ulcers at a primary health care centre in Kigali, Rwanda. Using clinical data and the results of a rapid plasma reagin (RPR) test, we simulated the diagnostic outcome of two simple WHO flowcharts for the management of genital ulcers. These outcomes and a clinical diagnosis were then compared with the laboratory diagnosis based on culture for genital herpes and Haemophilus ducreyi and serology for syphilis. The prevalence of HIV infection was high (73%) but there was no difference between HIV-positive and HIV-negative patients in the clinical presentation and etiology of genital ulcer disease. The proportion of correctly managed chancroid and/or syphilis cases was 99% using a syndromic approach, 82.1% using a hierarchical algorithm including an RPR test, and 38.3% with a clinical diagnosis. In situations where no laboratory support is available, a simple syndromic approach is preferable to the clinical approach for the management of genital ulcer. If an RPR test can be included in the diagnostic strategy, patients with a reactive RPR test should be treated for both syphilis and chancroid infection.

Authors+Show Affiliations

Laboratory of Microbiology, Centre Hospitalier de Kigali and Belgo-Rwandan Medical Cooperation, Rwanda.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8907769

Citation

Bogaerts, J, et al. "Simple Algorithms for the Management of Genital Ulcers: Evaluation in a Primary Health Care Centre in Kigali, Rwanda." Bulletin of the World Health Organization, vol. 73, no. 6, 1995, pp. 761-7.
Bogaerts J, Vuylsteke B, Martinez Tello W, et al. Simple algorithms for the management of genital ulcers: evaluation in a primary health care centre in Kigali, Rwanda. Bull World Health Organ. 1995;73(6):761-7.
Bogaerts, J., Vuylsteke, B., Martinez Tello, W., Mukantabana, V., Akingeneye, J., Laga, M., & Piot, P. (1995). Simple algorithms for the management of genital ulcers: evaluation in a primary health care centre in Kigali, Rwanda. Bulletin of the World Health Organization, 73(6), 761-7.
Bogaerts J, et al. Simple Algorithms for the Management of Genital Ulcers: Evaluation in a Primary Health Care Centre in Kigali, Rwanda. Bull World Health Organ. 1995;73(6):761-7. PubMed PMID: 8907769.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Simple algorithms for the management of genital ulcers: evaluation in a primary health care centre in Kigali, Rwanda. AU - Bogaerts,J, AU - Vuylsteke,B, AU - Martinez Tello,W, AU - Mukantabana,V, AU - Akingeneye,J, AU - Laga,M, AU - Piot,P, PY - 1995/1/1/pubmed PY - 1995/1/1/medline PY - 1995/1/1/entrez KW - Africa KW - Africa South Of The Sahara KW - Chancroid KW - Cross Sectional Analysis KW - Developing Countries KW - Diseases KW - Eastern Africa KW - Examinations And Diagnoses KW - French Speaking Africa KW - Herpes Genitalis KW - Hiv Infections KW - Infections KW - Reproductive Tract Infections--prevention and control KW - Research Methodology KW - Research Report KW - Rwanda KW - Sexually Transmitted Diseases--prevention and control KW - Syphilis KW - Treatment KW - Viral Diseases SP - 761 EP - 7 JF - Bulletin of the World Health Organization JO - Bull World Health Organ VL - 73 IS - 6 N2 - A cross-sectional study was conducted among 395 patients presenting with genital ulcers at a primary health care centre in Kigali, Rwanda. Using clinical data and the results of a rapid plasma reagin (RPR) test, we simulated the diagnostic outcome of two simple WHO flowcharts for the management of genital ulcers. These outcomes and a clinical diagnosis were then compared with the laboratory diagnosis based on culture for genital herpes and Haemophilus ducreyi and serology for syphilis. The prevalence of HIV infection was high (73%) but there was no difference between HIV-positive and HIV-negative patients in the clinical presentation and etiology of genital ulcer disease. The proportion of correctly managed chancroid and/or syphilis cases was 99% using a syndromic approach, 82.1% using a hierarchical algorithm including an RPR test, and 38.3% with a clinical diagnosis. In situations where no laboratory support is available, a simple syndromic approach is preferable to the clinical approach for the management of genital ulcer. If an RPR test can be included in the diagnostic strategy, patients with a reactive RPR test should be treated for both syphilis and chancroid infection. SN - 0042-9686 UR - https://www.unboundmedicine.com/medline/citation/8907769/Simple_algorithms_for_the_management_of_genital_ulcers:_evaluation_in_a_primary_health_care_centre_in_Kigali_Rwanda_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/8907769/ DB - PRIME DP - Unbound Medicine ER -