The Clinical Diagnosis of Genital Ulcer Disease in Men in the Tropics

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Abstract
A presumptive clinical diagnosis of chancroid, genital herpes, syphilis or lymphogranuloma venereum was made for 100 male patients at the Special Treatment Clinic in Nairobi, Kenya. This diagnosis was then compared to the final diagnosis determined by laboratory identification of the pathogen, by culture or by serologic response. In 64 patients, a final diagnosis of chancroid, syphilis or genital herpes was established. The diagnostic accuracy varied from 75% for chancroid to 42% for syphilis and 43% for herpes. The overall diagnostic accuracy was 66%. The predictive values of positive clinical diagnoses were 84% for chancroid, 60% for syphilis and 75% for herpes. Thus, clinical diagnosis of genital ulcer disease was not sufficiently reliable in this study.

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