Family Planning Perspectives
Volume 27, Number 4, December 2001

 

Strategies for Detection of Sexually Transmitted Infection Among Family Planning Clients in Jamaica
TABLES

 
Table 1. Percentage of family planning clients with gonorrhea, chlamydia or trichomoniasis, and bivariate and multivariable ods ratios (with 95% confidence intervals), all by selected characteristics, Kingston, Jamaica, 1995 (N=767)
Characteristic Prevalence Bivariate odds ratio Multivariate odds ratio
N %    
Total 182 23.7 na na
>=25 111 20.7 1.0 1.0
<25 71 30.6 1.7 (1.2-2.4) 1.6 (1.1-2.4)
Reported unpleasant vaginal odor
No 150 22.2 1.0 1.0
Yes 32 34.8 1.9 (1.2-3.0) 1.2 (0.7-2.1)
Reported bleeding/spotting after sex
No 162 22.7 1.0 1.0
Yes 20 37.0 2.0 (1.1-3.6) 1.5 (0.8-2.8)
Cervical friability
No 142 21.5 1.0 1.0
Yes 40 37.4 2.2 (1.4-3.4) 1.7 (1.1-2.8)
Urine dipstick
Neg./trace/+ 110 18.5 1.0 1.0
++/+++ 71 42.3 3.2 (2.2-4.7) 3.0 (2.0-4.4)
New partner in last 3 months*
No 158 22.7 1.0 ne
Yes 24 33.8 1.7 (1.0-2.9) ne
No. of partners in last 3 months*
1 154 21.9 1.0 ne
>=2 28 43.8 2.8 (1.6-4.7) ne
No. of partners in last year*
1 129 20.5 1.0 1.0
>=2 51 38.1 2.4 (1.6-3.5) 2.3 (1.5-3.6)
Has a casual partner*
No 170 22.9 1.0 ne
Yes 12 48.0 3.1 (1.4-6.9) ne
Partner may have other partners
No 33 16.4 1.0 1.0
Yes/do not know 148 26.2 1.8 (1.2-2.8) 1.5 (0.9-2.3)
Partner has urethral discharge
No 179 23.6 1.0 1.0
Yes 3 37.5 1.9 (0.5-8.2) 1.1 (0.2-5.6)
*Spearman correlation coefficients >=0.3 for having a new partner in the last 3 months, number of partners in last 3 months and number of partners in last year, and for number of partners in last 3 months, number of partners in last year and having a casual partner. Notes: na=not applicable; ne=not entered in model.

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Table 2. Percentage of family planning clients with (gonorrheal or chlamydial) cervical infection, and bivariate and multivariate odds ratios (with 95% confidence intervals), all by selected characteristics
Characteristic Prevalence Bivariate odds ratio Multivariate odds ratio
N %    
Total 108 14.1 na na
Age
>=25 63 11.8 1.0 1.0
<25 45 19.4 1.8 (1.2-2.7) 1.8 (1.2-2.8)
Reported unpleasant vaginal odor
No 90 13.3 1.0 1.0
Yes 18 19.6 1.6 (0.9-2.8) 1.0 (0.6-1.9)
Reported bleeding/spotting after sex
No 93 13.0 1.0 1.0
Yes 15 27.8 2.6 (1.4-4.8) 2.1 (1.1-4.1)
Cervical friability
No 80 12.1 1.0 1.0
Yes 28 26.2 2.6 (1.6-4.2) 2.2 (1.3-3.7)
Urine LED
Neg/trace/+ 68 11.4 1.0 1.0
++/+++ 39 23.2 2.3 (1.5-3.6) 2.1 (1.3-3.4)
New partner in last 3 months*
No 97 13.9 1.0 ne
Yes 11 15.5 1.1 (0.6-2.2) ne
No. of partners in last 3 months*
1 92 13.1 1.0 ne
>=2 16 25.0 2.2 (1.2-4.1) ne
No. of partners in last year*
1 79 12.6 1.0 1.0
>=2 28 20.9 1.8 (1.1-3.0) 1.7 (1.0-2.9)
Has a casual partner*
No 102 13.7 1.0 ne
Yes 6 24.0 2.0 (0.8-5.1) ne
Partner may have other partners
No 21 10.4 1.0 1.0
Yes/do not know 86 15.2 1.5 (0.9-2.6) 1.2 (0.7-2.0)
Partner has urethral discharge
No 105 13.8 1.0 1.0
Yes 3 37.5 3.7 (0.9-15.9) 3.0 (0.6-14.3)
*Spearman correlation coefficients >=0.3 for having a new partner in the last 3 months, number of partners in last 3 months and number of partners in last year, and for number of partners in last 3 months, number of partners in last year and having a casual partner. Notes: na=not applicable; ne=not entered in model.

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Figure 1. WHO algorithm modified for use in Jamaican STI clinics

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Table 3. Risk factors and scores, sensitivity, specificity, positive predictive value and decision criteria for selected decision models for identification of STIs among Jamaican family planning clients, according to type of STIs
Decision model and risk factors Sensitivity Specificity Positive predictive value Decision criteria
GONORRHEA/CHLAMYDIA/TRICHOMONIASIS
WHO algorithm* 57.7 46.2 25.0 Score >=2 or clinical signs (see Figure 1)
Age <21 (1)
New partner in 3 months (1)
>1 partner in last 3 months (1)
Not living with steady partner (1)
Partner has urethral discharge (2)
Weighted scoring model 1 62.4 69.0 38.6 Score >=9
Age <25 (5)
>1 partner in last year (9)
Cervical friability (6)
Urine leukocyte esterase (>=++) (11)
Weighted scoring model 2 59.1 69.4 37.5 Score >=9
Age <25 (5)
>1 partner in last year (9)
Spotting/bleeding after sex (6)
urine leukocyte esterase (>=++) (12)
Rapid risk assessment 70.7 59.7 35.4 Any 2
Age <25
>1 partner in last year
Partner has other partners
Partner has urethral discharge
Spotting/bleeding after sex
Urine leukocyte esterase (>=++)
Risk questions 53.6 67.5 33.9 Any 2
Age <25
>1 partner in last year
Partner has other partners
Partner has urethral discharge
Spotting/bleeding after sex
CERVICAL INFECTIONS (GONORRHEAL/CHLAMYDIAL)
WHO algorithm* 54.6 45.2 14.1 Score >=2 or clinical signs (see Figure 1)
New partner in 3 months (1)
>>1 partner in last 3 months (1)
Not living with steady partner (1)
Partner has urethral discharge (2)
Weighted scoring model 1 56.1 68.9 22.7 Score >=8
Age <25 (6)
>1 partner in last year (6)
Cervical friability (8)
Urine leukocyte esterase (>=++) (8)
Weighted scoring model 2 50.5 72.2 22.9 Score >=8
Age <25 (6)
>1 partner in last year (5)
Spotting/bleeding after sex (8)
urine leukocyte esterase (>=++) (9)
Rapid risk assessment 67.3 55.7 19.9 Any 2
Age <25
>1 partner in last year
Partner has other partners
Partner has urethral discharge
Spotting/bleeding after sex
Urine leukocyte esterase (>=++)
Risk questions 52.3 64.9 19.6 Any 2
Age <25
>1 partner in last year
Partner has other partners
Partner has urethral discharge
Spotting/bleeding after sex
*Modified for Jamaican STD clients. Note: Numbers in parenthesis are scores assigned to risk factors.

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© copyright 2001, The Alan Guttmacher Institute.