{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T12:49:59Z","timestamp":1775738999991,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T00:00:00Z","timestamp":1522022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effectiveness of the <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content> syndromic algorithm in the management of vaginal discharge among women of reproductive age in Dakar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional study of consecutive female patients (aged 18\u201349 years) presenting with vaginal symptoms at six selected study sites in Dakar; of these, 276 patients were included in the analysis. Vaginal and cervical swab samples were collected and analysed to establish an aetiological diagnosis of any infection. Syndrome\u2010based diagnosis was compared with the laboratory results to evaluate its accuracy based on sensitivity, specificity and positive and negative predictive values. The degree of agreement between the two approaches was assessed using the Cohen's kappa concordance analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall prevalence of vaginal infections was 56.9% (157\/276); 5.4% (15\/276) of the patients had cervical infection. Using the syndromic approach, 51% of patients were correctly managed for <jats:italic>Trichomonas vaginalis<\/jats:italic> (<jats:styled-content style=\"fixed-case\">TV<\/jats:styled-content>)\/<jats:italic>Gardnerella vaginalis<\/jats:italic> (<jats:styled-content style=\"fixed-case\">GV<\/jats:styled-content>); 61% for <jats:italic>Candida albicans<\/jats:italic> (<jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>) and 54% for <jats:italic>Chlamydia trachomatis<\/jats:italic> (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>)\/<jats:italic>Neisseria gonorrhoea<\/jats:italic> (<jats:styled-content style=\"fixed-case\">NG<\/jats:styled-content>) infections. Consequently, 31% of patients with <jats:styled-content style=\"fixed-case\">TV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">GV<\/jats:styled-content>, 51% with <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content> and 53% with <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">NG<\/jats:styled-content> infections would have missed treatment. Further, the kappa value was &lt;0.20, indicating that there was no agreement or only slight agreement between the syndromic approach and laboratory\u2010based diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study highlights the limitations of the applicability of the <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content> syndromic approach in settings with low prevalence of sexually transmitted infections (<jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content>s) and calls for affordable and accurate rapid tests for <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content>s.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13046","type":"journal-article","created":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T15:56:35Z","timestamp":1520265395000},"page":"541-548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Accuracy of syndromic management in targeting vaginal and cervical infections among symptomatic women of reproductive age attending primary care clinics in Dakar, Senegal"],"prefix":"10.1111","volume":"23","author":[{"given":"Mamadou Saidou","family":"Barry","sequence":"first","affiliation":[{"name":"Laboratoires SANOFI Afrique Subsaharienne Francophone Dakar S\u00e9n\u00e9gal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Awa","family":"Ba Diallo","sequence":"additional","affiliation":[{"name":"Laboratoire de Bact\u00e9riologie \u2013 Virologie CHU Aristide Le Dantec Dakar S\u00e9n\u00e9gal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Diadhiou","sequence":"additional","affiliation":[{"name":"Centre R\u00e9gional de Formation, de Recherche et de Plaidoyer en Sant\u00e9 de la Reproduction Dakar 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