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Sexually Transmitted Diseases
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Goals

Section 1
Section 2
Section 3

- Topics
- Introduction
- Objectives
- Approaches
- Laboratory
- Clinical
- Syndromic
- Syndromic
- Strengths
- Weaknesses
- Accuracy
- Genital Ulcer
- Algorithm
- Urethral
- Algorithm
- Vaginal
- Vaginitis
- Cervicitis
- Algorithms
- Algorithms
- Algorithms
- Abdominal
- PID
- Algorithm
- Algorithm
- Other Issues
- Treatment
> Screening
- The Four Cs
- Resources
- HIV Testing
- Vaccination
- Preliminary
- Summary

Summary

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Section 3 - STD Management

Asymptomatic Women: Screening

  • Tools other than laboratory tests are unreliable
    • risk assessment: mixed research findings
    • leukocyte esterase dipstick test: at least as predictive as risk assessment

  • Research on affordable reliable tests is ongoing

Slide 75


Several screening tools for determining if asymptomatic women have an STD have been tested, but none appears very reliable.

One approach is to use a risk assessment tool to screen all women at a particular site for possible infection. Using this tool, the provider asks all women demographic and behavioral questions, such as their recent sexual history, age and marital status. Studies have tested this approach in prenatal clinics, screening all women for gonorrhea and chlamydia, whether they had vaginal discharge or not. A study in rural Tanzania, for example, correctly found about seven of every 10 women who had gonorrhea or chlamydia. However, it incorrectly identified about seven uninfected women for every one true infection it found.

Leading uninfected people to believe they have an STD can produce emotional trauma. It may also cause problems between women and their partners, because it implies that one of them has been unfaithful.

Another screening tool under study is a simple urine test, the leukocyte esterase dipstick or LED test. Recent studies in Zaire and Jamaica found that the LED test was at least as predictive of STD infections as were the questions about risk factors. The LED test does not require laboratory facilities. It identifies infection through color charts that correspond with white blood cells found in urine. This test can be used in combination with a risk assessment.

Research on affordable, simple and reliable screening tests to identify gonorrhea and chlamydia among asymptomatic women is under way.

 

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