Self-Reported Symptoms of Reproductive Tract Infections: The Question of Accuracy and Meaning. A Case Study in Urban Pakistan

Durre Nayab, Australian National University

This paper is based on a community survey of women, of reproductive age, residing in Rawalpindi city, Pakistan. Each woman responded to a questionnaire soliciting reports of disease symptoms associated with reproductive tract infections (RTIs), along with their obstetric and contraceptive history, and socio-economic background. Consenting respondents were then taken to the hospital for a medical examination for the diagnosis of RTIs. Accuracy of self-reported symptoms is measured by comparing them with the medical diagnosis, using indicators of sensitivity, specificity, positive and negative predicted values, percentage of agreement and kappa statistics. Results show that self-reported symptoms of RTIs correspond poorly with the aetiological diagnosis, and measure a different aspect of illness. The reported symptoms were more psychogenic in nature than pathological and in most cases were a “bodily idiom of distress”. Attempts to improve the overall health of women need to address the meaning of self-reported symptoms.