Table of Contents
Volume 2014, Article ID 103452, 5 pages
Research Article

The Syndromic versus Laboratory Diagnosis of Sexually Transmitted Infections in Resource-Limited Settings

Harvard Medical School and Ragon Institute of MGH, MIT and Harvard, 400 Technology Square, Room 857, Cambridge, MA 02129, USA

Received 12 November 2013; Accepted 20 January 2014; Published 5 March 2014

Academic Editors: K. Arasteh, G. D’ettorre, and A. Guihot-Thevenin

Copyright © 2014 Musie Ghebremichael. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Sexually transmitted infections (STIs) are highly prevalent in sub-Saharan Africa, where there is a severe HIV epidemic. Thus, accurate recognition and diagnosis of STIs are essential for successful HIV prevention programs in the region. Due to lack of trained personnel and adequate laboratory infrastructure in the region, information regarding the profile of STIs relies essentially on self-reported or physician-diagnosed symptoms. The main objective of the study was to assess the effectiveness of the syndromic diagnosis of STIs, which is often used as a proxy for laboratory diagnosis of STIs in sub-Saharan Africa and other resource-limited settings. The study builds on previously collected data from a community-based survey in Northern Tanzania. We found no significant agreements between patient-reported STIs symptoms and laboratory-confirmed STIs tests. The reported STIs symptoms had high specificity (range = 85–99%) and poor sensitivity (range = 2–17%). Knowledge gained from our study will have significant public health implications, and can help improve the syndromic diagnosis of STIs.