RESUMO
BACKGROUND: Sexually transmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiânia, Brazil, and validated cervicitis diagnosis using World Health Organization/Ministry of Health risk score and gynecological examination. METHODS: A cross-sectional community-based sample of 914 15- to 19-year-old female teenagers was randomly selected and referred to the local Family Health Program. Of these, 472 (51.6%) were sexually active and gynecological examinations were carried out for 427. Endocervical samples were collected to perform the polymerase chain reaction for C. trachomatis and N. gonorrhoeae. Performance of risk score, the presence of mucopurulent discharge, friability, ectopia and pain during cervical maneuver were compared with the presence of C. trachomatis or N. gonorrhoeae or both. RESULTS: The prevalence of C. trachomatis and N. gonorrhoeae was 14.5% and 2.1%, respectively. The risk score had a specificity of 31.9% (95% confidence interval, 21.2 to 44.2) and a positive predictive value of 20.8% (95% confidence interval, 13.5 to 29.7). Friability was the component of the gynecological examination that presented the best performance with a sensitivity of 43.5%, specificity of 81.0%, and 30.6% of positive predictive value. CONCLUSION: The prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required.
Assuntos
Chlamydia trachomatis/isolamento & purificação , Gonorreia/diagnóstico , Pesquisa sobre Serviços de Saúde , Linfogranuloma Venéreo/diagnóstico , Programas de Rastreamento/métodos , Neisseria gonorrhoeae/isolamento & purificação , Adolescente , Brasil , Estudos Transversais , Feminino , Gonorreia/patologia , Gonorreia/fisiopatologia , Humanos , Linfogranuloma Venéreo/patologia , Linfogranuloma Venéreo/fisiopatologia , Exame Físico , Reação em Cadeia da Polimerase/métodos , Valor Preditivo dos Testes , Prevalência , Medição de Risco , Sensibilidade e Especificidade , População Urbana , Adulto JovemRESUMO
O linfogranuloma venéro (LGV) é uma doença infecto-contagiosa, de transmissäo sexual, causada pela Chlamydia tracomatis. É mais freqüente nas regiöes tropicais e subtropicais, áreas de menor desenvolvimento sócio-econômico e maior promiscuidade sexual.