1994•Unpublished venueRequires access
Genital ulcer disease: Accuracy ofclinical diagnosis andstrategies toimprove control in Durban, SouthAfrica
Nigel O’Farrell, Kathleen Coetzee
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Abstract
Objective-To investigate theaccuracy of clinical diagnosis ingenital ulcerdisease (GUD);todevise managementstrategies forimproving thecontrol ofGUD and thereby limit thespread ofHIV-1infection. Design-Clinical and microbiological assessment ofGUD inmen andwomen. Theindexofsuspicion, diagnostic accuracy,diagnostic efficiency andpositive andnegative predictive values ofaclinicaldiagnosis wereinvestigated. Setting-City HealthSexually TransmittedDiseases Clinic, KingEdward VIIIHospital, Durban, SouthAfrica. Participants-100 men and100women withgenital ulcers. Results-The accuracy ofaclinical diagnosiswas,in men: lymphogranuloma venereum(LGV)66%,donovanosis 63%, chancroid 42%,genital herpes39%,primarysyphilis 32%,mixedinfections 8%, andinwomen;secondary syphilis 94%, donovanosis 83%,genital herpes60%, primarysyphilis 58%,chancroid 57%, LGV40%,mixedinfections 14%.Overall, diagnostic efficiency was greaterin women thaninmen. When compared withothercausesofGUD,donovanosis ulcers bledtothetouchandwerelarger andnotusually associated withinguinal lymphadenopathy. Inwomen,extensive vulval condylomata latawerereadily dif