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Sex Transm Infect doi:10.1136/sti.2007.026914

Prevalence of Neisseria gonorrhoeae infection in young subjects attending community clinics in South London

  1. Guduru Gopal Rao (gopal.rao{at}uhl.nhs.uk)
  1. University Hospital Lewisham, United Kingdom
    1. Lesley Bacon (lesley.bacon{at}lewishampct.nhs.uk)
    1. Lewisham Primary Care Trust, United Kingdom
      1. Jacqui Evans (evaj{at}freeuk.com)
      1. Lewisham Primary Care Trust, United Kingdom
        1. Yemi Dejahang (yemi.dejahang{at}nhs.net)
        1. Lewisham Primary Care Trust, United Kingdom
          1. Paul Michalczyk (paul.michalczyk{at}uhl.nhs.uk)
          1. University Hospital Lewisham, United Kingdom
            1. Nora Donaldson (nora.donaldson{at}kcl.ac.uk)
            1. Kings College London, United Kingdom
              • Published Online First 27 September 2007

              Abstract

              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.

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