16 research outputs found
Flowchart of model to estimate number of adverse outcomes associated with syphilis in pregnancy.
<p>#, number.</p
Estimated number of adverse outcomes associated with syphilis in pregnancy averted in the middle scenario in 2008, and if Initiative for the Global Elimination of Congenital Syphilis targets for 2015 for testing and treatment had been met in 2008.
<p>ECS, Initiative for the Global Elimination of Congenital Syphilis.</p
Estimated number of adverse outcomes associated with syphilis in pregnancy in a worst, middle, and best case scenarios of testing and treatment in 2008.
<p>LBW, low birth weight.</p
PRISMA flowchart depicting screening process.
<p>PRISMA flowchart depicting screening process.</p
Measures used to determine the diagnostic accuracy.
<p>Measures used to determine the diagnostic accuracy.</p
Diagnostic performance of vaginal discharge for treating BV and/or TV.
<p>Diagnostic performance of vaginal discharge for treating BV and/or TV.</p
The Performance of the Vaginal Discharge Syndromic Management in Treating Vaginal and Cervical Infection: A Systematic Review and Meta-Analysis
<div><p>Background</p><p>This review aimed to synthesize and analyze the diagnostic accuracy and the likelihood of providing correct treatment of the syndromic approach Vaginal Discharge Flowchart in managing cervical infections caused by <i>Neisseria gonorrhoeae (NG)</i> and <i>Chlamydia trachomatis</i> (<i>CT)</i>, and vaginal infections caused by <i>Trichomonas vaginalis</i> (<i>TV)</i> and Bacterial vaginosis (BV) and <i>Candida albicans</i>. This review will inform updating the WHO 2003 guidelines on Vaginal Discharge syndromic case management.</p><p>Methods</p><p>A systematic review was conducted on published studies from 01-01-2000 to 30-03-2015 in multiple databases. Studies evaluating the diagnostic accuracy and validation of the WHO Vaginal Discharge Flowchart were included. Validation parameters including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and the 95% confidence intervals for the different types of the flowchart were taken as outcomes, re-calculated, and analysed using a fixed model meta-analysis for data pooling. The level of agreement between the index and reference test were determined by the Cohen’s Kappa co-efficiency test. Each individual study was assessed on quality using the QUADAS-2 tool.</p><p>Findings</p><p>The search yielded 2,845 studies of which 16 met the eligibility criteria for final analysis. The diagnostic performance to identify cervical infections was low and resulted in a high proportion of over and missed treatment. The four flowcharts had a sensitivity between 27.37% in history and risk assessment and 90.13% with microscopy, with the inverse in specificity rates. The treatment performances between the flowcharts were inconsistent. The same applies to the use of vaginal discharge flowchart for treating vaginal infections. For vaginal infections the vaginal discharge flowchart had a good performance in flowchart 3 with 91.68% of sensitivity; 99.97% specificity; 99.93% PPV and 0.02% who missed their treatment and 8.32% of women who were over treated by the vaginal discharge flowchart</p><p>Conclusion</p><p>The vaginal discharge flowchart should focus on management of vaginal infection. It could be used as an intermediate approach for cervical infections for sex workers until a point of care test is available in resource poor settings.</p></div
Pooled diagnostic validity- Cervical infection.
<p>Pooled diagnostic validity- Cervical infection.</p
Diagnostic performance of different vaginal flowcharts for treating NG and/or CT.
<p>Diagnostic performance of different vaginal flowcharts for treating NG and/or CT.</p