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Co-treatment for chlamydia is common practice when gonorrhoea is diagnosed in a UK genitourinary medicine setting. In Glasgow, the incidence of gonorrhoea across the city has tripled from 1995 to 2000.1 Given this rise, we investigated whether our practice of co-treatment was of continued benefit. We examined all patients presenting to the Glasgow Royal Infirmary Genitourinary Medicine (GUM) Service (including the Steve Retson Project service for gay men) between 1 April 1997 and 30 September 2000 who had genital gonorrhoea diagnosed on routine culture. We diagnosed genital chlamydia co-infection by ligase chain reaction (LCR) on first pass urine (for men) or endocervical swab (for women).
We diagnosed gonorrhoea in 351 attenders (287 men, 64 women), of whom 86 (25%; 95% CI 20% to 29%) were co-infected. Co-infection was significantly more common in women than men (29/64 (48%) v 57/287 (20%); p = 0.02). Homosexual or bisexual men were significantly less likely to be co-infected than heterosexual men (15/134 (11.0%) v 42/153 (28%); p = 0.001). Co-infection became less common with increasing age (15–19 years 43%; 20–24 years 34%; >24 years 18%; χ2 for trend = 15.4; p <0.0001) (see table w1 on STI website). Logistic regression modelling showed young age and female sex to be independent predictors of co-infection, while homo/bisexuality was protective (see table w2 on STI website).
We recommend continuing co-treatment for chlamydia in all women and heterosexual men presenting with gonorrhoea in our setting. However, in common with other recent findings2 co-infection with genital chlamydia is uncommon in male homosexual or bisexual attenders with genital gonorrhoea, and co-treatment may not be necessary in this group.
Presented in part at the MSSVD Spring Meeting May 2001.
Factors affecting co-infection with genital chlamydia and genital gonorrhoea in an urban genitourinary medicine clinic
L Hijazi, C Thow, and A J Winter
Table w1 Co-infection with genital chlamydial infection in GUM attenders with genital gonorrhoea: univariate analysis
Table w2 Co-infection with genital chlamydial infection in GUM attenders with genital gonorrhoea: results of logistic regression modelling. Odds ratio with 95 % confidence intervals (CI) were calculated using SPSS
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