clinical and laboratory positive predictive value of symptom management of sti in iran: a community-based survey

Background :the correct diagnosis of sexually transmitted infections (stis) is the first step in the monitoring and management of these diseases. objectives :this study was conducted to investigate the clinical and laboratory positive predictive value (ppv) of sti symptom management in iran. methods :this cross-sectional study was conducted on 5986 individuals (aged 18 to 50 years) from the general population of marovdasht (iran) in several stages: (1) self-reported symptoms of sexually transmitted diseases, (2) evaluation by a doctor, and (3) laboratory examination. results :among the population sample, 686 (17.68%) individuals reported at least one of the predefined symptoms. the clinical-based ppv of syndromes in men and women were 67.74 (62.34 - 73.14) and 85.36 (82.76 - 87.96), respectively. in men and women, the highest ppv was observed for abnormal discharge from the anus 32.35 (25.35 - 39.35) and abnormal secretions from the cervix 59.39 (56.39 - 62.39), respectively. the laboratory-based ppv for men and women was 0 and 5.04 (3.04 - 7.4), respectively. conclusions :the clinical and laboratory-based ppv of sti symptoms in the general population is extremely low. accordingly, a syndromic-based screening or monitoring approach for stis is not a reliable tool for screening or monitoring in the iranian general population. we suggest focusing on special (core) groups for monitoring stis using laboratory-based methods.