Abstract
BackgroundSexually transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiânia, Brazil, and validated cervicitis diagnosis using World Health Organization/Ministry of Health risk score and gynecological examination.MethodsA cross-sectional community-based sample of 914 15- to 19-year-old female teenagers was randomly selected and referred to the local Family Health Program. Of these, 472 (51.6%) were sexually active and gynecological examinations were carried out for 427. Endocervical samples were collected to perform the polymerase chain reaction for C. trachomatis and N. gonorrhoeae. Performance of risk score, the presence of mucopurulent discharge, friability, ectopia and pain during cervical maneuver were compared with the presence of C. trachomatis or N. gonorrhoeae or both.ResultsThe prevalence of C. trachomatis and N. gonorrhoeae was 14.5% and 2.1%, respectively. The risk score had a specificity of 31.9% (95% confidence interval, 21.2 to 44.2) and a positive predictive value of 20.8% (95% confidence interval, 13.5 to 29.7). Friability was the component of the gynecological examination that presented the best performance with a sensitivity of 43.5%, specificity of 81.0%, and 30.6% of positive predictive value.ConclusionThe prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required.
Highlights
Transmitted infections constitute the main health risk among adolescents
The aim of the present study was to validate the diagnosis of cervicitis due to C. trachomatis and N. gonorrhoeae using the World Health Organization (WHO)/ Ministry of Health risk score and gynecological examination in a population-based sample of female adolescents in Brazil
The WHO/Ministry of Health risk score and gynecological examination data The prevalence of infection with C. trachomatis was expressively high (14.5%; 95% confidence interval (CI) 11.4 to 18.3), while the prev
Summary
Transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiânia, Brazil, and validated cervicitis diagnosis using World Health Organization/ Ministry of Health risk score and gynecological examination. Transmitted infections (STI) constitute the main health risk among sexually active adolescents [1], as confirmed by data from developed countries where statistical systems are well-organized. The aim of the present study was to validate the diagnosis of cervicitis due to C. trachomatis and N. gonorrhoeae using the WHO/ Ministry of Health risk score and gynecological examination in a population-based sample of female adolescents in Brazil
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