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Table 4 Sex-stratified sensitivity analyses of syndromic screening for genital tract infections (GTIs) among sexually experienced, non-pregnant South African youth (aged 16–24 years) enrolled in the AYAZAZI study (n = 352)

From: A high burden of asymptomatic genital tract infections undermines the syndromic management approach among adolescents and young adults in South Africa: implications for HIV prevention efforts

Syndrome Symptomatic Laboratory test (gold standard) Total Sensitivity (%)
[95% CI]
Specificity (%)
[95% CI]
PPV (%)
[95% CI]
NPV (%)
[95% CI]
Positive Negative      
Females (n = 198)
 Vaginal discharge (VDS)a Yes 19 2 21 13.7 96.6 90.5 32.2
No 120 57 177 [8.4–20.5] [88.2–99.6] [69.6–98.8] [25.4–39.6]
  with cervical STIs as causative agentsb Yes 7 14 21 11.7 89.9 33.3 70.1
No 53 124 177 [4.8–22.6] [83.6–94.3] [14.6–57.0] [62.7–76.7]
  with vaginal STIs as causative agentsc Yes 18 3 21 14.8 96.1 85.7 41.2
No 104 73 177 [9.0–22.3] [88.9–99.2] [63.7–97.0] [33.9–48.9]
  with only BV as a causative agent Yes 14 7 21 13.3 92.5 66.7 48.6
No 91 86 177 [7.5–21.4] [85.1–96.9] [43.0–85.4] [41.0–56.2]
 Lower abdominal pain (LAP)d Yes 4 9 13 7.0 93.4 30.8 70.6
No 53 127 180 [1.9–17.0] [87.8–97.0] [9.1–61.4] [63.3–77.1]
Males (n = 154)
 Male urethritis (MUS)e Yes 0 1 1 0.0 99.3 0.0 89.5
No 16 137 153 [0–20.6]g [96.0–100.0] [0–97.5]g [83.6–93.9]
 Scrotal Swelling (SSW)f Yes 0 0 0 0.0 100.0 N/A 91.6
No 13 141 154 [0–24.7]g [97.4–100.0]g [N/A] [86.0–95.4]
  1. Notes: GTIs included as the gold standard for VDS, LAP, MUS and SSW include (note: no sensitivity analysis was performed for GUD given testing via genital swabs and NAAT:
  2. aAny STI/GTI with VDS as a syndrome: N.gonorrhoeae, C.trachomatis, M.genitalium (cervical infection), T.vaginalis, BV, or C. albicans (vaginal infection);
  3. bAny cervical STI with VDS as a syndrome: N.gonorrhoeae, C.trachomatis, M.genitalium;
  4. cAny vaginal STI with VDS as a syndrome: T.vaginalis, BV, C. albicans;
  5. dAny STI/GTI with LAP as a syndrome: N.gonorrhoeae, C.trachomatis, M.genitalium
  6. eAny STI with MUS as syndrome: N.gonorrhoeae, C.trachomatis, M.genitalium, T.vaginalis;
  7. fAny STI with SSW as syndrome: N.gonorrhoeae, C.trachomatis;
  8. g1-sided 97.5% CI