PT  - JOURNAL ARTICLE
AU  - Emily Kerubo
AU  - Kayla F Laserson
AU  - Newton Otecko
AU  - Collins Odhiambo
AU  - Linda Mason
AU  - Elizabeth Nyothach
AU  - Kelvin O Oruko
AU  - Ashley Bauman
AU  - John Vulule
AU  - Clement Zeh
AU  - Penelope A Phillips-Howard
TI  - Prevalence of reproductive tract infections and the predictive value of girls’ symptom-based reporting: findings from a cross-sectional survey in rural western Kenya
AID  - 10.1136/sextrans-2015-052371
DP  - 2016 Jun 01
TA  - Sexually Transmitted Infections
PG  - 251--256
VI  - 92
IP  - 4
4099  - http://sti.bmj.com/content/92/4/251.short
4100  - http://sti.bmj.com/content/92/4/251.full
SO  - Sex Transm Infect2016 Jun 01; 92
AB  - Objectives Reproductive tract infections (RTIs), including sexually acquired, among adolescent girls is a public health concern, but few studies have measured prevalence in low-middle-income countries. The objective of this study was to examine prevalence in rural schoolgirls in Kenya against their reported symptoms.Methods In 2013, a survey was conducted in 542 adolescent schoolgirls aged 14–17 years who were enrolled in a menstrual feasibility study. Vaginal self-swabbing was conducted after girls were interviewed face-to-face by trained nurses on symptoms. The prevalence of girls with symptoms and laboratory-confirmed infections, and the sensitivity, specificity, positive and negative predictive values of symptoms compared with laboratory results, were calculated.Results Of 515 girls agreeing to self-swab, 510 answered symptom questions. A quarter (24%) reported one or more symptoms; most commonly vaginal discharge (11%), pain (9%) or itching (4%). Laboratory tests confirmed 28% of girls had one or more RTI. Prevalence rose with age; among girls aged 16–17 years, 33% had infections. Bacterial vaginosis was the most common (18%), followed by Candida albicans (9%), Chlamydia trachomatis (3%), Trichomonas vaginalis (3%) and Neisseria gonorrhoeae (1%). Reported symptoms had a low sensitivity and positive predictive value. Three-quarters of girls with bacterial vaginosis and C. albicans, and 50% with T. vaginalis were asymptomatic.Conclusions There is a high prevalence of adolescent schoolgirls with RTI in rural Kenya. Public efforts are required to identify and treat infections among girls to reduce longer-term sequelae but poor reliability of symptom reporting minimises utility of symptom-based diagnosis in this population.Trial registration number ISRCTN17486946.