Attached
Background: Trichomoniasis is a sexually transmitted parasitic infection. The World Health Organization (WHO)
v rivocated flow charts for curable sexually transmitted infections (STIs) to improve the care. In this study, an attempt
was made to evaluate the validity and reliability of WHO syndromic algorithm for vaginal discharge against
trichomonas immunochromatographic test (ICT). Trichomonas ICT is a test with high validity, reliability, and
feasibility. Objectives: The objective was to evaluate the validity and reliability of "WHO syndromic algorithm for
vaginal discharge" against "trichomonas ICT" as a screening tool for trichomonas infection among women of
reproductive age in the Western Province, Sri Lanka. Materials and Methods: This cross-sectional study was
conducted in sexually transmitted disease clinics, well woman clinics, gynecology clinics, and institutional health
clinics in the Western Province, Sri Lanka. We enrolled 100 women in die age group of 15-45 years using the stratified
random sampling method. They were interviewed and examined and the specimens were collected to identify
trichomoniasis by culture and ICT. Two-stage analyses were done to evaluate the performance of the WHO algorithm
against Trichomonas ICT. Results: In a two-stage analysis, the specificity of syndromic algorithm improved from
80.9% to 94.4% while false positive rate reduced from 19.1% to 5.6%. The net effect of specificity was 98.7% while
the false positive rate was 1.3%. Conclusion: The validity and reliability of WHO syndromic algorithm as a diagnostic
tool for trichomoniasis can be improved by adding trichomonas ICT
