Surveillance and etiological studies - a prerequisite for optimization of management of infectious gynecological conditions

Abstract

In order to allocate adequate resources for health care of gynecological infections (G.I.), a reliable surveillance program, is mandatory. Also, to be able to propose screening programs and to be able to calculate the cost-effectiveness of such initiative (which may even gain money to the society) even in a short-term perspective. To be able to recommend therapy in syndrome-based management of G.I. and to propose a reasonable battery of tests to work-up cases consulting with symptoms that can be assumed to be caused by such infections, etiologically studies should be performed at regular intervals in each hospital (or regional) catchment area.

Full Text

In order to allocate adequate resources for health care of gynecological infections (G.I.), a reliable surveillance program, is mandatory. Also, to be able to propose screening programs and to be able to calculate the cost-effectiveness of such initiative (which may even gain money to the society) even in a short-term perspective. To be able to recommend therapy in syndrome-based management of G.I. and to propose a reasonable battery of tests to work-up cases consulting with symptoms that can be assumed to be caused by such infections, etiologically studies should be performed at regular intervals in each hospital (or regional) catchment area. General recommendations based on studies performed only some years ago may be non- valid. Rapid changes in the etiological spectrum has occurred in many areas. It is also essential to up-date recommendations on antibiotic treatment. Once such recommendations have been given, it is important that they are up-dated on a regular basis if necessary. Today many outdated recommendations do exist. Also due to the rapid change in the technology of diagnostic tests it is mandatory that laboratories use tests that are not only optimal in relation to sensitivity and specificity and has an acceptable positive predictive value. That is the test that also works well in populations with a low prevalence of the specific G.I. searched for.