LIMITED PREDICTIVE VALUE OF VAGINAL DISCHARGE AND CERVICAL ECTROPION FOR Chlamydia trachomatis INFECTION DETECTED BY DIRECT IMMUNOFLUORESCENCE

Authors

• Dian Novitasari, Master Program of Reproductive Health Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
• Willy Sandhika, Department of Anatomic Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaFollow
• Ashon Sa'adi, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
• Lusiani Tjandra, Department of Pharmacology, Faculty of Medicine, Universitas Wijaya Kusuma Surabaya, Indonesia

ORCID ID

Dian Novitasari: https://orcid.org/0009-0001-0279-9165

Willy Sandhika: https://orcid.org/0000-0002-8499-1600

Ashon Sa'adi: https://orcid.org/0000-0003-2682-3139

Lusiani Tjandra: https://orcid.org/0000-0002-0387-3179

Abstract

Chlamydia trachomatis is one of the most common sexually transmitted infections, often asymptomatic, yet a major cause of infertility. In clinical practice, vaginal discharge and cervical ectropion are frequently used as syndromic indicators. However, their predictive value for Chlamydia trachomatis infection remains limited, particularly in regions with restricted access to NAAT/PCR, such as Indonesia. This study aimed to evaluate the diagnostic value of vaginal discharge and cervical ectropion as predictors of Chlamydia trachomatis infection using the Direct Immunofluorescence (DIF) method. This study used a cross-sectional design conducted among 93 reproductive-aged women from coastal areas of Jember, East Java, Indonesia, who were considered at increased risk for sexually transmitted infections. Endocervical and lateral vaginal smears were collected and examined using DIF microscopy with Chlamydia trachomatis-specific monoclonal antibodies. The authors assessed vaginal discharge in 82 women and evaluated cervical ectropion status in all participants. We analyzed associations between clinical findings and infection status using the Chi-square test, with p < 0.05 considered statistically significant. Chlamydia trachomatis infection was detected in 47.2% of women with vaginal discharge and 34.8% of those without, demonstrating no statistically significant difference (p = 0.254). Similarly, we identified infection in 33.3% of women with cervical ectropion and 48.5% of those without, also without significant association (p = 0.182). These findings suggest that vaginal discharge and cervical ectropion have limited value as standalone clinical predictors of Chlamydia trachomatis infection. While NAAT/PCR remains the diagnostic gold standard, DIF may serve as a feasible alternative in resource-limited settings. Integrating laboratory-based diagnostic approaches may improve case detection compared to reliance on syndromic management alone.

Keywords

Chlamydia trachomatis; reproductive health; sexually transmitted infection; syndromic management

First Page

63

Last Page

69

DOI

10.65346/2599-056X.2430

Publication Date

6-30-2026

Recommended Citation

Novitasari, Dian; Sandhika, Willy; Sa'adi, Ashon; and Tjandra, Lusiani. 2026 LIMITED PREDICTIVE VALUE OF VAGINAL DISCHARGE AND CERVICAL ECTROPION FOR Chlamydia trachomatis INFECTION DETECTED BY DIRECT IMMUNOFLUORESCENCE. Folia Medica Indonesiana. 62, 1 (Jun. 2026 ), 63-69.
Available at: https://doi.org/10.65346/2599-056X.2430