Nathalie Broutet

World Health Organization

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Edna Kara

World Health Organization

Françis Mégraud

Université de Bordeaux

Anna Thorson

World Health Organization

Maribel Almonte

World Health Organization

Rolando Herrero

Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud

Melanie Taylor

Centers for Disease Control and Prevention

Lori Newman

National Institute of Allergy and Infectious Diseases

Sami L. Gottlieb

World Health Organization - Pakistan

Nicola Low

University of Bern

Armando Baena

Centre International de Recherche sur le Cancer

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World Health Organization

158

World Health Organization - Pakistan

Centers for Disease Control and Prevention

University of Birmingham

John Wiley & Sons (United States)

Hudson Institute

London School of Hygiene & Tropical Medicine

University of Washington

Harvard University

Fundação Oswaldo Cruz

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The Performance of the Vaginal Discharge Syndromic Management in Treating Vaginal and Cervical Infection: A Systematic Review and Meta-Analysis

PLoS ONE (2016)

Charifa Zemouri Teodora Wi James Kiarie Armando Seuc Vittal Mogasale

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 Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), and vaginal infections caused by Trichomonas vaginalis (TV) and Bacterial vaginosis (BV) and Candida albicans. This review will inform updating the WHO 2003 guidelines on Vaginal Discharge syndromic case management.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.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.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.

Vaginal discharge

Vaginal infections

10.1371/journal.pone.0163365

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Citations (71)

Issue Information

International Journal of Cancer (2023)

Brechtje D.M. Koopmann Amir‐Houshang Omidvari Iris Lansdorp‐Vogelaar Djuna L. Cahen Marco Brayda‐Bruno

Robust evidence on the effectiveness of pancreatic cancer screening is lacking, as published studies are mostly cohort studies, limited in size and duration.Here, the authors performed a systematic review to evaluate the impact of pancreatic cancer screening on life expectancy as determined in model-based studies.The results show that, while it could be detrimental in the general population, pancreatic cancer screening in high-risk populations may increase life expectancy.Updated model studies, with data from large clinical trials, are necessary to predict the long-term effect of pancreatic cancer screening more accurately.

10.1002/ijc.34078

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Citations (0)

Additional file 1 of Phase II trial evaluating the clinical efficacy of cefixime for treatment of active syphilis in non-pregnant women in Brazil (CeBra)

Figshare (2020)

Melanie Taylor Edna Kara Maria Alix Leite Araújo Mariângela Freitas da Silveira Angélica Espinosa Miranda

Additional file 1. Randomization of participants following the permuted block randomization 2:1 method.

Cefixime

10.6084/m9.figshare.12502904

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Supplementary Table 2 from Cervical Cancer Screening and Treatment Algorithms Using Human Papillomavirus Testing—Lessons Learnt from a South African Pilot Randomized Controlled Trial

Hannah M. Sebitloane Mathilde Forestier Themba G. Ginindza Wendy Dhlomo Eshia Moodley-Govender

<p>Supplementary Table 2: HPV positivity from self- and nurse-taken samples in VIA triage arm, by HIV status</p>

Table (database)

10.1158/1055-9965.25957010.v1

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Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus: results from the ESTAMPA multicentric screening study

The Lancet Global Health (2023)

Joan Valls Armando Baena Gino Venegas Marcela Celis Mauricio González

Triage

Cervical screening

10.1016/s2214-109x(22)00545-9

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Citations (23)

Association of serum pepsinogen with atrophic body gastritis in Costa Rica

Clinical and Experimental Medicine (2006)

Rosa A. Sierra Clas Une Vanessa Ramírez Ma. Isabel González José Antonio Ramírez

Atrophic gastritis

CagA

10.1007/s10238-006-0098-3

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Citations (24)

World Health Organization Guidelines: Use of cryotherapy for cervical intraepithelial neoplasia

International Journal of Gynecology & Obstetrics (2012)

Nancy Santesso Holger J. Schünemann Paul D. Blumenthal Hugo De Vuyst Julia C. Gage

Cryotherapy

Evidence-Based Medicine

10.1016/j.ijgo.2012.01.029

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Citations (61)

Multicentric study of cervical cancer screening with human papillomavirus testing and assessment of triage methods in Latin America: the ESTAMPA screening study protocol

BMJ Open (2020)

Maribel Almonte Raúl Murillo Gloria Inés Sánchez Paula González Annabelle Ferrera

Introduction Human papillomavirus (HPV) testing is replacing cytology in primary screening. Its limited specificity demands using a second (triage) test to better identify women at high-risk of cervical disease. Cytology represents the immediate triage but its low sensitivity might hamper HPV testing sensitivity, particularly in low-income and middle-income countries (LMICs), where cytology performance has been suboptimal. The ESTAMPA (EStudio multicéntrico de TAMizaje y triaje de cáncer de cuello uterino con pruebas del virus del PApiloma humano; Spanish acronym) study will: (1) evaluate the performance of different triage techniques to detect cervical precancer and (2) inform on how to implement HPV-based screening programmes in LMIC. Methods and analysis Women aged 30–64 years are screened with HPV testing and Pap across 12 study centres in Latin America. Screened positives have colposcopy with biopsy and treatment of lesions. Women with no evident disease are recalled 18 months later for another HPV test; those HPV-positive undergo colposcopy with biopsy and treatment as needed. Biological specimens are collected in different visits for triage testing, which is not used for clinical management. The study outcome is histological high-grade squamous intraepithelial or worse lesions (HSIL+) under the lower anogenital squamous terminology. About 50 000 women will be screened and 500 HSIL+ cases detected (at initial and 18 months screening). Performance measures (sensitivity, specificity and predictive values) of triage techniques to detect HSIL+ will be estimated and compared with adjustment by age and study centre. Ethics and dissemination The study protocol has been approved by the Ethics Committee of the International Agency for Research on Cancer (IARC), of the Pan American Health Organisation (PAHO) and by those in each participating centre. A Data and Safety Monitoring Board (DSMB) has been established to monitor progress of the study, assure participant safety, advice on scientific conduct and analysis and suggest protocol improvements. Study findings will be published in peer-reviewed journals and presented at scientific meetings. Trial registration number NCT01881659

Triage

10.1136/bmjopen-2019-035796

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Citations (27)

WHO global research priorities for sexually transmitted infections

The Lancet Global Health (2024)

Sami L. Gottlieb Erica Spielman Laith J. Abu‐Raddad Adeniyi Kolade Aderoba Laura H. Bachmann

Global Health

10.1016/s2214-109x(24)00266-3

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Citations (11)

Comprehensive Cervical Cancer Control: Strategies and Guidelines