Syndromic approach to vulvoginal candidiasis in primary care

Objective: The aim of this study is to form syndromic components in which anamnesis and gynaecological examination findings could be used in vulvoginal candidiasis diagnosis in primary care .Method : The research was completed with 245 female patients who applied to Dr. Ekrem Hayri Üstündağ Gynecology and Obstetrics Hospital?s oncology, gynecology and family planning departments with vaginal complaints aged between 15-49 in accordance with inclusion criteria. It is a diagnosis test study. The questionnaire form examining the sociodemographic characteristics and complaints of all participants was filled by face-to-face interview method and following this step, gynaecological examination of the patients was carried out. Required materials for laboratory workups were obtained by appropriate methods in the course of examination. The evidence derived from the study was evaluated by SPSS for Windows 16.0 and Microsoft Office Excel 2003 programmes used for statistical analyses. In the statistical assessment of the data; descriptive analyses, chi-square analysis, Kruskall Wallis and Mann-Whitney U tests were employed. The susceptibility, specificity, positive and negative likelihood ratio (LR) and post-test probabilities of the criteria found significant were estimated. These criteria were divided into three groups as weak, medium and strong according to their +LR values. Post test probabilities were calculated by using chain LR method for variables in each group and variables in different groups.Results: Criteria were divided into three groups according to their calculated LR values. 12 weak, 6 medium and 2 strong criteria were discovered. In the presence of 5 criteria out of 12 weak ones, 3 out of 6 weak ones and 1 out of 2 weak ones, post-test likelihood value can be obtained which is able to approach to the level of diagnosis (>65%). In the presence of 1 weak, one medium and one strong criteria having lowest +LR values, diagnosis can be reached with 86,24 % accuracy rate by post-test probabilities calculated by chain LR method.Conclusion: Vulvoginal candidiasis for women seeking medical advice as to vaginal complaints can be diagnosed by utilizing criteria index which can facilitate clinical decision making thanks to findings acquired by syndromic approach (in view of anamnesis obtained from patients and gynaecological examination outcomes) in primary care.