Urine screening for gonococcal and chlamydial infections at community-based organizations in a high-morbidity area.
BACKGROUND
Increasing availability of urine testing for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) offers expanded opportunities to collaborate with community-based organizations (CBOs) to screen high-risk populations for sexually transmitted diseases (STDs).


OBJECTIVE
To determine the prevalence and correlates of genital tract gonococcal and chlamydial infection among CBO clients, and to assess the feasibility of implementing widespread community-based STD screening programs.


METHODS
Free, voluntary, confidential first-catch urine screening was conducted at 20 CBOs serving disadvantaged populations in St. Louis, MO. Brief demographic, behavioral, and sexual contact data were obtained from all participants. Urine samples were tested by ligase chain reaction (LCR). Persons testing positive were promptly notified and directed to seek treatment.


RESULTS
A GC and/or CT infection was identified in 24 of 277 persons (8.7%) screened; 2 persons were infected with GC only, 17 with CT only, and 5 with GC and CT. Treatment was documented for 22 persons (91.7%) testing positive. The highest rates of infection were found at shelters (12.3%) and residence facilities (11.1%). Costs of screening were $38 per sample collected and $453 per case identified.


CONCLUSIONS
Community-based urine testing successfully identified GC and CT infections, and was well accepted by community members and CBOs. Community-based screening can significantly impact STD epidemiology by facilitating early detection, treatment, and interruption of transmission.
Jones
C A
CA
Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Knaup
R C
RC
Hayes
M
M
Stoner
B P
BP
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine*; D002692:Chlamydia trachomatis; D003153:Community Health Services / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D009017:Morbidity; D011204:Poverty Areas; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014504:Urban Health