Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Aug 8, 2017; 6(3): 154-160
Published online Aug 8, 2017. doi: 10.5409/wjcp.v6.i3.154
Screening for asymptomatic chlamydia and gonorrhea in adolescent males in an urban pediatric emergency department
Megan E Maraynes, Jennifer H Chao, Konstantinos Agoritsas, Richard Sinert, Shahriar Zehtabchi
Megan E Maraynes, Ochsner Medical Center, University of Queensland, Jefferson, LA 70121, United States
Jennifer H Chao, Konstantinos Agoritsas, Richard Sinert, Shahriar Zehtabchi, SUNY Downstate Medical Center and the Kings County Hospital Center, Brooklyn, NY 11203, United States
Author contributions: All authors contributed to this paper.
Institutional review board statement: The State University of New York Downstate institutional review board approved the study protocol.
Informed consent statement: All participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We have no conflicts of interest to disclose.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Megan E Maraynes, MD, FAAP, Section Head, Ochsner Medical Center, University of Queensland, 1514 Jefferson Highway, Jefferson, LA 70121, United States. megan.maraynes@ochsner.org
Telephone: +1-914-4190533
Received: January 19, 2017
Peer-review started: January 19, 2017
First decision: April 19, 2017
Revised: May 24, 2017
Accepted: June 12, 2017
Article in press: June 13, 2017
Published online: August 8, 2017
Processing time: 193 Days and 21.2 Hours
Abstract
AIM

To determine the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhea (GC) in young men seeking care in the emergency department (ED) for non-sexually transmitted infection (STI) related symptoms.

METHODS

This was a prospective, cross-sectional study in an urban ED. The main outcome was the rate of positive CT and GC on urine nucleic acid amplification testing in males aged 16-21 presenting with non-STI related complaints.

RESULTS

Two hundred and eighty-four patients were enrolled, 271 were included in the final data analysis [age range 16-21, median: 18 (quartiles 16-18, 19-21)]. Overall, 17 (6.3%, 95%CI: 4%-10%) tested positive for CT and 0% (95%CI: 0%-2%) were found to have GC. The proportion of sexually active subjects was 71% (95%CI: 65%-76%) and 2% (95%CI: 0.6%-4%) reported sex with men. Previous STI testing was reported in 46% (95%CI: 43%-54%) and 13% (95%CI: 8%-20%) of those patients previously tested had a history of STI. Of the patients who tested positive for CT in the ED, 88% (95%CI: 64%-98%) were successfully followed up.

CONCLUSION

The prevalence of CT infection found by screening was 6.3%. Screening and follow-up from the ED was successful. The findings justify routine STI screening in male adolescents presenting to the ED with non-STI related complaints.

Keywords: Chlamydia; Gonorrhea; Adolescent; Public health; Emergency department; Pediatric

Core tip: Chlamydia trachomatis and Neisseria gonorrhea are the most common bacterial sexually transmitted infections (STIs), the sequelae of which are among the most costly of any STI except human immunodeficiency virus infection and acquired immune deficiency syndrome. Disease is often asymptomatic in young males, for whom there is a lack of consensus on screening recommendations and who are screened less often than women. Most studies on emergency department screening focus on young females, or group both asymptomatic and symptomatic patients together. We found 6.3% prevalence of asymptomatic Chlamydia by screening adolescent males who were not seeking screening and would likely not otherwise have been tested.