Evaluation of sexual history-based screening of anatomic sites for chlamydia trachomatis and neisseria gonorrhoeae infection in men having sex with men in routine practice

BMC Infectious Diseases

Servaas A Morré²  A Petra van Leeuwen³  Casper L Jansen¹  Johan Mutsaers¹  Sander Ouburg²  Noëmi Nijsten⁴  Stephan P Verweij²  Remco PH Peters⁵ 

[1] Department of Medical Microbiology, MCH Westeinde Hospital, The Hague, The Netherlands;Laboratory of Immunogenetics, Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands;Cluster of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands;The Hague Municipal Health Services, STI clinic, The Hague, The Netherlands;ANOVA Health Institute, Khutšo Kurhula Offices, Tzaneen, South Africa

关键词: screening;    oropharyngeal;    anorectal;    Neisseria gonorrhoeae;    Chlamydia trachomatis;   

Others  :  1175646
DOI  :  10.1186/1471-2334-11-203

 received in 2011-03-04, accepted in 2011-07-26,  发布年份 2011

【 摘 要 】

Background

Sexually transmitted infection (STI) screening programmes are implemented in many countries to decrease burden of STI and to improve sexual health. Screening for Chlamydia trachomatis and Neisseria gonorrhoeae has a prominent role in these protocols. Most of the screening programmes concerning men having sex with men (MSM) are based on opportunistic urethral testing. In The Netherlands, a history-based approach is used. The aim of this study is to evaluate the protocol of screening anatomic sites for C. trachomatis and N. gonorrhoeae infection based on sexual history in MSM in routine practice in The Netherlands.

Methods

All MSM visiting the clinic for STI in The Hague are routinely asked about their sexual practice during consulting. As per protocol, tests for urogenital, oropharyngeal and anorectal infection are obtained based on reported site(s) of sexual contact. All consultations are entered into a database as part of the national STI monitoring system. Data of an 18 months period were retrieved from this database and analysed.

Results

A total of 1455 consultations in MSM were registered during the study period. The prevalence of C. trachomatis and N. gonorrhoeae per anatomic site was: urethral infection 4.0% respectively and 2.8%, oropharynx 1.5% and 4.2%, and anorectum 8.2% and 6.0%. The majority of chlamydia cases (72%) involved a single anatomic site, which was especially manifest for anorectal infections (79%), while 42% of gonorrhoea cases were single site. Twenty-six percent of MSM with anorectal chlamydia and 17% with anorectal gonorrhoea reported symptoms of proctitis; none of the oropharyngeal infections were symptomatic. Most cases of anorectal infection (83%) and oropharyngeal infection (100%) would have remained undiagnosed with a symptom-based protocol.

Conclusions

The current strategy of sexual-history based screening of multiple anatomic sites for chlamydia and gonorrhoea in MSM is a useful and valid guideline which is to be preferred over a symptom-based screening protocol.

【 授权许可】

   
2011 Peters et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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