Abstract：
PURPOSE OF REVIEW:This review aims to determine the effectiveness of the use of syndrome diagnosis in the evaluation of vaginitis and to make suggestions based on the review findings. RECENT FINDINGS:Vaginal discharge as the main symptom of vaginitis is unspecific. A randomized study of symptom-based diagnosis and treatment of vaginitis in the USA favored symptoms used for treatment; however, this was only a pilot study. Hence, a population-based study is necessary to validate these findings. Most of the study that assessed treatment of vaginitis in pregnancy reported low diagnostic sensitivity and specificity for bacterial vaginosis and vaginal candidiasis and a wide range for trichomonas vaginalis reflecting ineffectiveness of syndrome-based treatment in pregnancy. A systematic review of the web for relevant literature was made, and appropriate articles were extracted and reviewed. Sensitivity, specificity, and positive values were used, where applicable to determine effectiveness. Forty-three full articles and abstracts were reviewed. Studies that validated or applied WHO algorithm for treatment of vaginitis reported high sensitivity (91.5-100%) but moderate to low specificity (0-27.5%) among women with vaginal symptoms. Studies that focused on symptoms for diagnosis of the three main etiologic agents of vaginitis reported low sensitivity and specificity, while such studies in pregnancy reported sensitivity and specificity ranging from 35.4 to 54% for TV, 11 to 100% for BV, and 0 to 56.2% for trichomonas vaginalis, bacterial vaginosis, and vaginal candidiasis, respectively. Studies that added point of care test reported higher sensitivity and specificity and positive predictive value. The use of WHO syndrome-based algorithm or its modification for treatment of vaginitis though moderately effective has the potential for overtreatment and physician error. Point of care testing and laboratory investigation are essential for productive intervention especially in pregnancy.
journal_name
Curr Infect Dis Repjournal_title
Current infectious disease reportsauthors
Nwankwo TO,Aniebue UU,Umeh UAdoi
10.1007/s11908-017-0558-9subject
Has Abstractpub_date
2017-01-01 00:00:00pages
3issue
1eissn
1523-3847issn
1534-3146pii
10.1007/s11908-017-0558-9journal_volume
19pub_type
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更新日期：2011-06-01 00:00:00
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更新日期：2017-09-23 00:00:00
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更新日期：2019-03-02 00:00:00
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更新日期：2016-06-01 00:00:00
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更新日期：2012-08-01 00:00:00
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更新日期：2010-07-01 00:00:00
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pub_type： 杂志文章
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