A flowchart for managing sexually transmitted infections among Nigerian adolescent females

objective: to devise a flowchart suitable for assessing risk of trichomoniasis, chlamydia and gonorrhoea in an adolescent population, not all of whom will be sexually experienced or currently in a relationship. methods: the data used to derive the flowchart were generated from cross-sectional microbiological surveys of girls aged 14-19 years in port harcourt, nigeria. the flowchart screened on the basis of: (i) sexual experience; (ii) recent sexual activity; (iii) a positive urine leukocyte esterase (le) test; and (iv) among le negatives, a history of malodorous/pruritic discharge. findings: using this flowchart, we found that 26.2% of all adolescents screened would receive treatment for cervicitis and vaginitis. chlamydial, gonococcal, and trichomonal infections were correctly diagnosed in 37.5%, 66.7%, and 50 % of the cases, respectively. conclusion: although the flowchart is more suitable for an adolescent population than the vaginal discharge algorithm used in syndromic management protocols, it still lacks precision and needs adapting to local settings.