Objectives: To describe the prevalence and epidemiology of gonococcal infection in young subjects attending community clinics in South-East London.
Methods: Subjects <25 years participating in National Chlamydia Screening Programme were tested for gonococcal infection using a nucleic acid amplification test (Strand Displacement assay).
Results: 10,523 tests were performed in 7369 patients (82% female) over a two-year period in 2004 and 2005. Specimens used for tests were self-taken vulvovaginal swabs (43%), cervical swabs (40%), urine (16%) and urethral swabs (0.9%). Reasons for tests were: screening (67%), diagnosis (27%) and contacts of patients with chlamydia or gonococcus infection (7%). Significantly higher percentage of males were tested as contacts (M:19% v F:4%; P<0.001) Of the 10,117 cases with definite results, 414 were positive (Prevalence: 4.1%, 95% C.I. 3.7%-4.5%). There was a significantly higher prevalence in males (Males: 5.7% v Females: 3.8%; P<0.001). The average number of tests was 1.4 per patient (Range 1-10) Contacts had significantly higher prevalence (15.5%, P<0.001) than those tested for diagnostic (3.6%) or screening (3.1%) purposes. Multivariate regression analysis confirmed that there was significantly higher prevalence was in Black-Caribbean (5.8%, OR 2.44), Black-British/Other(5.6%, OR 2.33) and Mixed(5.5%, OR 2.25) compared to the White(2.4%) ethnic groups.( P<0.001) . Increasing age was significantly associated with lower prevalence (OR=0.87; 95% C.I. 0.84-0.91; P<0.001). The odds of a positive test decreased by 13% for every year older.
Conclusion: Community-screening programme has detected a high prevalence of N.gonorrhoeae in South London, especially in teenagers, males, and certain ethnic groups.
- Neisseria gonorrhoeae