Huge burden of undiagnosed gonorrhoea and Chlamydia due to sole testing of urogenital sites

While routine multi-site testing for gonorrhoea and Chlamydia in men who have sex with men (MSM) is increasingly becoming the standard of care, the same is not true for heterosexual women who may also practice oral and anal sexual intercourse. A group of Dutch investigators have reported a study exploring the number of missed infections if only the urogenital site was tested using nucleic acid amplification tests.1 Sampling of the urogenital site was considered to be urine or swabs taken from the urethra, vagina or cervix. A missed infection is considered to be one occurring in the throat or rectum where the urogenital sample is negative.

Between 2006 and 2010, a total of 207 134 new consultations occurred in women. Chlamydia testing was also performed either from the pharynx or rectum in 17.6%. For Chlamydia, the positivity rates were 10.4%, 9.3% and less than 3% for vaginal, anorectal and pharyngeal samples respectively. About 13% of Chlamydia infections would …