Diagnosing Pelvic Inflammatory Disease with Limited Diagnostic Tools in a Region of Ghana

The objective of this study was to describe how pelvic inflammatory disease (PID) is diagnosed in a region with limited technological diagnostic tools. Subsequently, we retrospectively reviewed 208 PID case notes and interviewed 25 clinicians in two regional level and four district hospitals of the Central Region of Ghana We found out that the clinical diagnosis of PID was frequently based on the features of lower abdominal pain, vaginal discharge, fever, lower abdominal tenderness, cervical motion, and adnexal tenderness. Sexual histories of suspected cases were rarely obtained while menstrual and contraceptive histories were scanty. Fifty-one per cent and two per cent of patients received bimanual and vaginal speculum examinations respectively. Predisposing factors were observed in 23 per cent of patients. There was a notion that poor genital hygiene was a cause of PID. We conclude that the periodic audit of clinical management of PID even in the absence of objective diagnostic tools is essential in identifying issues that could improve case prevention, recognition, and management. (Afr J Reprod Health 1999; 3 [1]: 88 - 97) Key Words: Pelvic inflammatory disease, diagnosis, Ghana