1. Urethral infection in a workplace population of East African men: evaluation of strategies for screening and management.
- Author
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Jackson DJ, Rakwar JP, Chohan B, Mandaliya K, Bwayo JJ, Ndinya-Achola JO, Nagelkerke NJ, Kreiss JK, and Moses S
- Subjects
- Adolescent, Adult, Africa epidemiology, Bacterial Infections diagnosis, Bacterial Infections therapy, Chlamydia Infections diagnosis, Chlamydia Infections epidemiology, Chlamydia Infections therapy, Female, Gonorrhea diagnosis, Gonorrhea epidemiology, Gonorrhea therapy, Humans, Male, Middle Aged, Trichomonas Vaginitis diagnosis, Trichomonas Vaginitis epidemiology, Trichomonas Vaginitis therapy, Urethral Diseases diagnosis, Urethral Diseases therapy, Workplace, Bacterial Infections epidemiology, Urethral Diseases epidemiology
- Abstract
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.
- Published
- 1997
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