Evidence map›Paper›PMID 29288183›Full record

ArticleBMJ open2017

Performance of syndromic management for the detection and treatment of genital

Lisa M Vallely, Pamela Toliman, Claire Ryan, Glennis Rai, Johanna Wapling, Josephine Gabuzzi, Joyce Allen, Christine Opa, Gloria Munnull, Petronia Kaima and 10 more

Open access · goldAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 2 pooled it
2.9field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.

  1. Pooled it
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  5. Observational
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  7. EnhancedOpen forum infectious diseases · 2025
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  18. Prevalence and determinants of genitalSexually transmitted infections · 2021
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 7 institutions in 2 countries.

Lisa M VallelyPublic Health Interventions Research Group, Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Pamela TolimanPublic Health Interventions Research Group, Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Claire RyanThe Macfarlane Burnet Institute for Medical Research and Public Health, Burnet Institute, Melbourne, Victoria, Australia.
Glennis RaiSchool of Medicine and Health Sciences, University of Papua New Guinea, Boroko, Papua New Guinea.
Johanna WaplingThe Macfarlane Burnet Institute for Medical Research and Public Health, Burnet Institute, Melbourne, Victoria, Australia.
Josephine GabuzziSexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Boroko, Papua New Guinea.
Joyce AllenSexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Boroko, Papua New Guinea.
Christine OpaSexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Boroko, Papua New Guinea.
Gloria MunnullSexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Boroko, Papua New Guinea.
Petronia KaimaTininga clinic, Mt Hagen General Hospital, Mount Hagen, Papua New Guinea.
Benny KombukObstetrics and Gynaecology, Mt Hagen General Hospital, Mount Hagen, Papua New Guinea.
Antonia KumbiaObstetrics and Gynaecology, Eastern Highlands Provincial Hospital, Goroka, Papua New Guinea.
Zure KombatiDepartment of Pathology, Mt Hagen General Hospital, Mt Hagen, Papua New Guinea.
Greg LawSexual Health and Disease Control Branch, National Department of Health, Poert Moresby, Papua New Guinea.
Angela Kelly-HankuSexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Boroko, Papua New Guinea.
Handan WandBiostatistics and Database Program, Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Peter M SibaFormer Director, Papua New Guinea Institute of Medical Research, Port Moresby, Papua New Guinea.
Glen D L MolaSchool of Medicine and Health Sciences, University of Papua New Guinea, Boroko, Papua New Guinea.
John M KaldorPublic Health Interventions Research Group, Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Andrew J VallelyPublic Health Interventions Research Group, Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-1558-4822
Papua New Guinea Institute of Medical Research · PGUNSW Sydney · AUMount Hagen Provincial Hospital · PGBurnet Institute · AUUniversity of Papua New Guinea · PGGoroka Base Hospital · PGNational Department of Health · PG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePapua New Guinea (PNG) has among the highest estimated prevalences of genital

designWomen attending antenatal (ANC), well woman (WWC) and sexual health (SHC) clinics in four provinces were invited to participate, completed a face-to-face interview and clinical examination, and provided genital specimens for laboratory testing. We estimated the performance characteristics of syndromic diagnoses against combined laboratory diagnoses.

results1764 women were enrolled (ANC=765; WWC=614; SHC=385). The prevalences of CT, NG and TV were highest among women attending ANC and SHC. Among antenatal women, syndromic diagnosis of sexually transmitted infection had low sensitivity (9%-21%) and positive predictive value (PPV) (7%-37%), but high specificity (76%-89%) and moderate negative predictive value (NPV) (55%-86%) for the combined endpoint of laboratory-confirmed CT, NG or TV. Among women attending WWC and SHC, 'vaginal discharge syndrome' had moderate to high sensitivity (72%-78%) and NPV (62%-94%), but low specificity (26%-33%) and PPV (8%-38%). 'Lower abdominal pain syndrome' had low sensitivity (26%-41%) and PPV (8%-23%) but moderate specificity (66%-68%) and high NPV (74%-93%) among women attending WWC, and moderate-high sensitivity (67%-79%) and NPV (62%-86%) but low specificity (26%-28%) and PPV (14%-33%) among SHC attendees.

conclusionThe performance of syndromic management for the detection and treatment of genital chlamydia, gonorrhoea and trichomonas was poor among women in different clinical settings in PNG. New diagnostic strategies are needed to control these infections and to prevent their adverse health outcomes in PNG and other high-burden countries.

Indexed as

Abdominal PainAdultAmbulatory Care FacilitiesChlamydia InfectionsChlamydia trachomatisClinical Laboratory TechniquesDiagnostic ServicesDiagnostic Techniques and ProceduresFemaleGenitalia, FemaleGonorrheaHumansNeisseria gonorrhoeaePregnancyPregnancy Complications, InfectiousPrenatal Caresexually transmitted infections

Identifiers

PMID29288183
PMCPMC5778337
OpenAlexW2780163788

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.