{
  "abstract": "Introduction Reproductive tract infections (RTIs) including sexually transmitted infections (STIs) result in major reproductive health morbidity worldwide. There is a paucity of recent data on laboratory-confirmed prevalence in India of the curable pathogens responsible, Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Trichomonas vaginalis (TV), Bacterial vaginosis (BV) and Candida albicans (CA), with a significant proportion being asymptomatic. This study aims to determine the diagnostic accuracy of the syndromic approach and the prevalence of symptomatic and asymptomatic infections.Method An observational study was conducted with 440 married, reproductive age women in low-income and middle-income neighbourhoods of Delhi. Vaginal swabs were collected irrespective of symptoms. Nucleic acid amplification technique was used for NG, TV and CT, gram stain for CA and Nugent’s criteria for BV.Statistical analysis was done using STATA V.16.1. Categorical variables were analysed using the binomial exact method. Sensitivity, specificity, positive and negative predictive value, and likelihood ratios were calculated for the syndromic approach. Logistic regression was performed to assess associated factors.Result 262 of 440 women had a positive laboratory test. BV was 37%, CA 12.7%, CT, NG and TV were <1%. 56% of asymptomatic women had a laboratory confirmed RTI. Sensitivity and specificity of syndromic approach were 62% and 45%. Every 1-year increase in age of women was associated with an 8% reduction in the odds of having a lab-confirmed STI/RTI (OR=0.92).Conclusions BV and CA were most prevalent infections. A syndromic approach had low sensitivity and specificity; young age was a risk factor.Trial registration number CTRI/2020/03/023954.",
  "authors": [
    {
      "affiliations": [
        "Society for Applied Studies, New Delhi, India"
      ],
      "name": "Neeta Dhabhai"
    },
    {
      "affiliations": [
        "Society for Applied Studies, New Delhi, India"
      ],
      "name": "Barsha Gadapani Pathak"
    },
    {
      "affiliations": [
        "Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland"
      ],
      "name": "Gitau Mburu"
    },
    {
      "affiliations": [
        "Society for Applied Studies, New Delhi, India"
      ],
      "name": "Deepak More"
    },
    {
      "affiliations": [
        "Society for Applied Studies, New Delhi, India"
      ],
      "name": "Ranadip Chowdhury"
    },
    {
      "affiliations": [
        "Department of Global HIV Hepatitis and Sexually Transmitted Infections Programmes, World Health Organisation, Geneva, Switzerland"
      ],
      "name": "Teodora E C Wi"
    },
    {
      "affiliations": [
        "Dr Dangs Lab LLP, New Delhi, India"
      ],
      "name": "Leena Chatterjee"
    },
    {
      "affiliations": [
        "Dr Dangs Lab LLP, New Delhi, India"
      ],
      "name": "Devjani De"
    },
    {
      "affiliations": [
        "Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland"
      ],
      "name": "Rita Kabra"
    },
    {
      "affiliations": [
        "Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland"
      ],
      "name": "James Kiarie"
    },
    {
      "affiliations": [
        "Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland"
      ],
      "name": "Ndema Habib"
    },
    {
      "affiliations": [
        "Dr Dangs Lab LLP, New Delhi, India"
      ],
      "name": "Arjun Dang"
    },
    {
      "affiliations": [
        "Dr Dangs Lab LLP, New Delhi, India"
      ],
      "name": "Manvi Dang"
    },
    {
      "affiliations": [
        "Department of Microbiology, Vardhman Medical College and Safdarjung Hospital, New Delhi, India"
      ],
      "name": "Aradhna Bhargav"
    },
    {
      "affiliations": [
        "Dr Dangs Lab LLP, New Delhi, India"
      ],
      "name": "Binish Jawed"
    },
    {
      "affiliations": [
        "Society for Applied Studies, New Delhi, India"
      ],
      "name": "Sarmila Mazumder"
    }
  ],
  "title": "Prevalence of reproductive tract and sexually transmitted infections among symptomatic and asymptomatic women, validity of syndromic management, in urban and periurban low to mid socioeconomic neighbourhoods of North Delhi: an observational study",
  "uid": "684a3300-8a7d-5be8-b278-f0f8900914d1"
}