TY - JOUR
T1 - Urethral infection in a workplace population of East African men
T2 - Evaluation of strategies for screening and management
AU - Jackson, Denis J.
AU - Rakwar, Joel P.
AU - Chohan, Bhavna
AU - Mandaliya, Kishorchandra
AU - Bwayo, Job J.
AU - Ndinya-Achola, Jeckoniah O.
AU - Nagelkerke, Nico J.D.
AU - Kreiss, Joan K.
AU - Moses, Stephen
PY - 1997
Y1 - 1997
N2 - Transport workers (n = 504) in Mombasa, Kenya, were screened for urethral infection by history, clinical examination, and laboratory testing of urethral swabs and first-catch urine specimens. The prevalence of Neisseria gonorrhoeae was 3.4%, Chlamydia trachomatis, 3.6%, and Trichomonas vaginalis, 6.0%; more than two-thirds of infections were asymptomatic. A complaint of urethral discharge, dysuria, or both was twice as sensitive as the sign of discharge on physical examination (34.5% vs. 15.5%) in identifying infection. A positive leukocyte esterase dipstick (LED) test on urine predicted infection with a sensitivity of 95.0% and a specificity of 59.3% in symptomatic men and with a sensitivity of 55.3% and a specificity of 82.8% in asymptomatic men. Demographic and behavioral factors were not independent predictors of infection. In resource-poor settings with high prevalences of urethral infection, an effective screening and management strategy would be to treat symptomatic men, as well as asymptomatic men with a positive LED test, for all three infections.
AB - Transport workers (n = 504) in Mombasa, Kenya, were screened for urethral infection by history, clinical examination, and laboratory testing of urethral swabs and first-catch urine specimens. The prevalence of Neisseria gonorrhoeae was 3.4%, Chlamydia trachomatis, 3.6%, and Trichomonas vaginalis, 6.0%; more than two-thirds of infections were asymptomatic. A complaint of urethral discharge, dysuria, or both was twice as sensitive as the sign of discharge on physical examination (34.5% vs. 15.5%) in identifying infection. A positive leukocyte esterase dipstick (LED) test on urine predicted infection with a sensitivity of 95.0% and a specificity of 59.3% in symptomatic men and with a sensitivity of 55.3% and a specificity of 82.8% in asymptomatic men. Demographic and behavioral factors were not independent predictors of infection. In resource-poor settings with high prevalences of urethral infection, an effective screening and management strategy would be to treat symptomatic men, as well as asymptomatic men with a positive LED test, for all three infections.
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U2 - 10.1086/513979
DO - 10.1086/513979
M3 - Article
C2 - 9086138
AN - SCOPUS:0030893882
SN - 0022-1899
VL - 175
SP - 833
EP - 838
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 4
ER -