In sub-Saharan Africa where sexually transmitted diseases (STDs) are prevalent but health resources are scarce, algorithms that act as STD/HIV risk assessment (RA) tools for family planning (FP) and maternal/child heath (MCH) clinic attenders may be useful.
These RA algorithms generally comprise questions about a person's social, economic, demographic, behavioural and clinical background.
The answers can be scored or scaled to indicate a higher probability of current STD/HIV infection and thus the need for testing or treatment.
RA can be done alone, or can be combined with clinical examination where laboratory diagnosis is not feasible.
But how accurate are RA tools ?
We reviewed six studies at African sites that examined the use of RA combined with a clinical algorithm for STD screening of clinic attendees.
Researchers reported the standard measures of test accuracy : sensitivity (per cent of infected women found positive by the tool) ; specificity (per cent of uninfected women found negative by the tool), and positive predictive value (per cent of women found positive by the tool who are truly infected).
Most algorithms had low sensitivity (<50%) and low positive predictive value (<20%). The addition of clinical examination, and of leucocyte esterase (LE) testing, improved accuracy.
But algorithms that performed well in one site were less accurate at other sites.
For illustrative purposes, we considered a hypothetical population of 1,000 women attending a FP clinic. (...)
Mots-clés Pascal : Maladie sexuellement transmissible, Dépistage, Facteur risque, Epidémiologie, Etude comparative, Tanzanie, Afrique, Kenya, Zaïre, Homme, Femelle
Mots-clés Pascal anglais : Sexually transmitted disease, Medical screening, Risk factor, Epidemiology, Comparative study, Tanzania, Africa, Kenya, Zaire, Human, Female
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0226555
Code Inist : 002B05B02H. Création : 11/09/1998.