Prevalence and Factors Associated With Gonorrhea and Chlamydial Infection in At-Risk Females Presenting to an Urban Emergency Department

• Published in: Sexually transmitted diseases 2003-04, Vol.30 (4), p.335-339
• Main Authors: BACHMANN, LAURA H., PIGOTT, DAVID, DESMOND, RENEE, JONES, MARGA, LUMPKINS, JACQUELINE, GALA, PRERNA, TERNDRUP, THOMAS, HOOK, EDWARD W.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Alabama - epidemiology; Bacterial diseases; Bacterial diseases of the genital system; Biological and medical sciences; Chlamydia Infections - epidemiology; Chlamydia Infections - etiology; Chlamydia Infections - prevention & control; Chlamydia trachomatis - isolation & purification; Delivery of Health Care; Emergency Service, Hospital - statistics & numerical data; Emergency services; Female; Females; Gonorrhea - epidemiology; Gonorrhea - etiology; Gonorrhea - prevention & control; Health risk assessment; Human bacterial diseases; Humans; Infections; Infectious diseases; Medical sciences; Neisseria gonorrhoeae - isolation & purification; Outcome Assessment (Health Care); Prevalence; Risk Factors; Sexual Partners; Sexually transmitted diseases; STD; Surveys and Questionnaires; Urban areas; Urban Health
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/00007435-200304000-00012

Background: Patients without a regular healthcare source are less likely to be tested, diagnosed, and treated effectively for sexually transmitted diseases (STDs). Emergency departments (EDs) are a major healthcare source for patients without health insurance or primary care providers. Goal: This study evaluated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in women aged 15 to 35 years presenting to a metropolitan ED with genitourinary or pregnancy-related complaints and the frequency with which patients were effectively treated for these infections during routine ED care. Study Design: Women completed an interviewer-administered questionnaire and submitted urine for ligase chain reaction (LCR) testing for trachomatis and N gonorrhoeae. Results: The combined prevalence of gonorrhea and chlamydia was 16.4% (n = 62), and factors associated with infection included younger age and greater numbers of sex partners over 30 days. Problemoriented care failed to detect infection in most cases, and 58% of infected women left the ED without effective therapy. Through a close working relationship with the local health department, we documented that 92% had received effective follow-up therapy. Conclusion: Continued efforts to refine and develop tools for the diagnosis and management of cervical infections for at-risk women seen in EDs are warranted.