Accuracy Level of Syndrome Management in Diagnosing Gonorrhea and Chlamydia in Pregnant Women with Vaginal Discharge Complaints

Abstract

This study aims to assess the accuracy of syndrome management in diagnosing cervicitis caused by Neisseria gonorrhoeae (NG) or gonorrhea and Chlamydia trachomatis (CT) or chlamydia in pregnant women with vaginal discharge complaints, by comparing the accuracy of symptom-based syndrome management with an etiology-based laboratory approach. A Systematic Literature Review was conducted, searching five databases: PubMed, Cochrane, Google Scholar, and Garuda. The inclusion criteria included studies on pregnant women, comparisons between syndrome-based and laboratory-based management, and the presentation of diagnostic accuracy (sensitivity, specificity, positive predictive value, and negative predictive value). The quality of the studies was critically appraised using the QUADAS-2 instrument, and results were synthesized narratively. From the literature search, 673 studies were identified, of which 2 met the eligibility criteria for final analysis. The analysis revealed that syndrome management had low sensitivity (18–45%), moderate to high specificity (69–83%), low positive predictive value (10–24%), and high negative predictive value (77–92%). Syndrome-based management was found to be less accurate in detecting cervicitis, especially in asymptomatic cases, potentially leading to under-treatment or over-treatment. In contrast, laboratory-based etiology approaches such as NAAT demonstrated higher accuracy and are recommended as a more reliable diagnostic method.