Comparison of syndromic diagnosis of reproductive tract infections with laboratory diagnosis among rural married women in Medak district, Andhra Pradesh

INTRODUCTION: In developing countries, reproductive tract infections (RTI) commonly affect the quality of life. Many reproductive tract infections including sexually transmitted infections (STI) and cervical cancers remain asymptomatic for long periods. Syndromic case management (SCM) is the mainstay in the control of RTI/STI, especially at primary level, where laboratory diagnosis is not possible. However, lab diagnosis should be used when it is available. OBJECTIVE: To assess the consistency of syndromic diagnosis with laboratory diagnosis. MATERIALS AND METHODS: A total of 407 women were screened. Women were categorized according to Syndromic Diagnosis of RTI/STI based on history and clinical examination. Microbiological tests and Pap smears were done to confirm the diagnosis and compared with Syndromic Diagnosis. RESULTS: Microbiologically, 33.14% were positive for at least one organism. Bacterial vaginosis was the most common finding (14%). Pap smear showed 32.9% inflammatory changes and 0.25% low-grade squamous intraepithelial lesion. Sensitivity and specificity of syndromic diagnosis with laboratory findings: Vaginal discharge syndrome with microbiological tests- (Se 58.9; Sp55.1%) Lower abdominal pain syndrome with microbiological tests-(Se 14.4%; Sp76.6%) CONCLUSION: The findings of this study highlight the wide variation of syndromic and laboratory diagnosis.