Objectives:Todeterminetheaetiologiesofvaginaldischargesyndromes,tocalculatetheperformanceofdifferentmanagementalgorithms,andvalidatethesealgorithmsinSTDclinicsinChina.ThesealgorithmswereadoptedfromthoseproposedbytheWorldHealthOrganization.Methods:Atotalof315consecutivepatientswithvaginaldischargewereenrolledatthreeSTDclinics.CervicalinfectionwasdefinedaspresenceofNeisseriagonorrhoeaeoncultureand/orChlamydiatrachomatisbypolymerasechainreaction.OtherlaboratorytestsincludedwetmountmicroscopyandpHtestingofvaginalfluid.Sensitivity,specificity,andpositivepredictivevalueofdifferentalgorithmsweredeterminedusingstandardmethods.Results:Cervicalinfectionwasidentifiedin37.8%ofpatients(20.6%gonorrhea,12.7%chlamydialinfection,4.4%gonorrheaincombinationwithchlamydialinfection).Thesensitivity,specificity,andpositivepredictivevalueofalgorithmsAandBfortheidentificationofNeisseriagonorrhoeaeand/orChlamydiatrachomatiswererespectively71.4%and90.8%,65.3%and46.9%,55.6%and50.9%.Conclusions:Thevaginaldischargealgorithmscouldbeappliedforclinicalmanagement.Theirsensitivitiesareacceptable.However,thereisaneedtofurtherimprovetheirspecificityandpositivepredictivevalue.Thetwoalgorithmscouldbeusedinclinicalsettingswithdifferentfacilities.Thesealgorithmsshouldalsobevalidatedinpopulationswithlowerdiseaseprevalence.
