Diagnostic accuracy of ultrasound scans for the diagnosis of pelvic inflammatory disease keeping laboratory high vaginal swab/urine microscopy culture as gold standard in Anambra State, Nigeria

Abstract

Ultrasound scanning (USS) and high vaginal swab culture and urine microscopy culture and sensitivity (m/c/s) tests are the most common investigations used for the diagnosis of pelvic inflammatory disease (PID) in our locality. The aim of this study was to determine the diagnostic accuracy of ultrasound in the diagnosis of PID keeping laboratory high vaginal swab/urine microscopy, culture as gold standard. The USS, high vaginal swab and urine m/c/s reports of patients referred with PID conditions between January 2010 to April 2013 were obtained from the medical records departments of Nnamdi Azikiwe University teaching hospital, Nnewi, Anambra state. The diagnostic accuracy was determined by calculating sensitivity, specificity, positive predictive value and negative predictive value using performance characteristics test. Descriptive and inferential statistics were also used. Spearman rho's non parametric analysis and statistical package for social sciences (SPSS) version 17.0 was equally used. The total number of subjects that were scanned for PID was 120. The highest number of subjects 80 (66.6%) was seen in 21 to 30 years age group. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of ultrasound in PID diagnosis was found to be 100, 65.3, 89.2, 100 and 86.3%, respectively. There was no significant correlation between USS diagnosis of PID and HVS/urine culture findings (p > 0.01). Ultrasound is valuable as the first line of investigation (screening tool) in the diagnosis of PID and should be used in conjunction with other medical investigations to facilitate accurate diagnosis of PID.

How popular is X-ray hysterosalpingography in the investigation of infertility by radiographers and radiologists in Nigeria?

“…This number appears low when compared with the fact that within a 9 month period in 2008 in a single hospital in Pakistan, there were 1,124 HSG cases [15]. The sharp drop in number of HSG cases in our locality may be due to the fact that ultrasound is used as the first line of investigation of infertility [8].…”

“…In Radiology departments in the country, infertility is the special investigation with the highest throughput, and with ultrasound being the modality of choice for first line investigation [7]. Although ultrasound is sensitive for masses in the genital tract, it has limited sensitivity and specificity for tubal patency [8]. Hysterosalpingography (HSG) however, has high sensitivity and specificity for tubal patency [4,9], although it carries inherent radiation risks [10].…”

Effect of Sharbat-e-Deenarin uncomplicated Pelvic Inflammatory Disease- A Clinical study

“…Higher prevalence of PID in women between 20-30 years of age is in accordance with the indings of Eze JC. et al (Eze et al, 2018)as this is the sexually active group. Mean age of patients was 28.23±4.97, which is in accordance with the study of Sayed A. et al (Sayed et al, 2016) (Savaris et al, 2007)reported 28.3±0.8 and 29.3±1.1yrs, in two groups.…”

Efficacy of transabdominal pelvic ultrasound in the detection of pelvic inflammatory disease

“…Pelvic inflammatory disease (PID) is a polymicrobial disease often developed in young or child-bearing aged women . PID is characterized by upper genital tract infection endometritis, metroendometritis, parametritis, salpingo-oophoritis, and pelvic peritonitis, which may lead to developing tuboovarian abscess (Eze et al 2018). According to Xia et al (2022), the diagnosis can be directly made by ultrasound, but 100% of it can only be confirmed by hysteroscopy and histological examination of the endometrium.…”