Frecuencia de infecciones del tracto genital femenino en mujeres sintomáticas y uso de pruebas rápidas para su diagnóstico en dos poblaciones de Bogotá (Colombia) 2008: Estudio piloto

Objectives:  describing the frequency and etiology of genital tract infections in two selected groups of women. Methodology : this was a cross-sectional study which included females having symptoms of vaginal discharge or itching who consulted during 2007-2008 at three sites in Bogota, Colombia. They were aged 14 to 49. The following exclusion criteria were used: females having severe medical conditions, a history of hysterectomy, being pregnant, presenting menstrual discharge, having no history of sexual activity or those who reported having received antibiotic therapy during the previous 14 days. Sequential sampling. Syndromic diagnosis was stablished according to the World Health Organization guidelines. Definitive diagnosis was made by PCR (Polymerase Chain Reaction) for  C. trachomatis , culturing for  N. gonorrhoeae  and  Candida , treponemal tests for syphilis, direct exam for  Trichomonas vaginalis , nugent’s test for bacterial vaginosis and serological detection for human immunodeficiency virus (HIV). Sensitivity and specificity of the rapid diagnostic tests used were determined against the “gold standard” diagnostic test for each infection. Results : one hundred and thirty-one females were included. Bacterial vaginosis was present in 46% of the patients, followed by candidiasis in 16%. Syphilis was the most frequently diagnosed sexually-transmitted infection in 7% of cases and  C. trachomatis  in 6%.  Trichomonas vaginalis  was observed in two patients but no cases of  N. gonorrhoeae  were identified. The most frequent syndromic diagnosis was vaginitis. The rapid diagnostic tests had close to 100% specificity; sensitivity varied from 90% for syphilis, to 81% for bacterial vaginosis and 60% for  Candida . The frequency of positive cases for  Chlamydia  and  gonorrhoeae  was too low to assess the rapid tests’ diagnostic precision. Conclusions : genital tract infections in the symptomatic women studied here were mainly endogenous. The overall frequency of sexually transmitted infection in these selected populations was 16%. Rapid diagnostic tests may be used at the point-of-care. Additional research is urgently needed; a larger sample should be used for accurately assessing rapid tests’ diagnostic precision.