CLINICAL ALGORITHMS FOR THE SCREENING OF CHLAMYDIA-TRACHOMATIS IN TURKISH WOMEN

Objective: To test the diagnostic validity of clinical algorithms for the detection of Chlamydia trachomatis in an urban population of marri ed women in Turkey. Design: Cross-sectional population-based survey. S ubjects: A systematic sample of 867 women who reported the use of cont raceptive methods. Main outcome measures: Sensitivity, specificity and positive predictive value of clinical algorithms for the diagnosis of C trachomatis. Results: C trachomatis was diagnosed in 4.89% of the w omen. The WHO algorithm for use in settings where no vaginal examinati on could be performed had a sensitivity of 9% and a specificity of 96% . The corresponding figures for the WHO algorithm incorporating the fi ndings of a speculum examination were 47% and 56% respectively. Algori thms incorporating symptoms or signs other than those suggested by the WHO did not yield satisfactory standards of validity. Conclusions: Th e findings of this study do not support the widespread introduction of the use of clinical decision models for screening of women for chlamy dia infection in primary health care settings such as family planning or antenatal clinics. The large number of false positive results with the use of the clinical algorithms tested in this study would cause un necessary costs to the health system and unnecessary interventions to the women treated.