title: Using urinary leucocyte esterase tests as an indicator of infection with gonorrhoea or chlamydia in asymptomatic males in a primary health care setting.
abstract: To evaluate a leucocyte esterase test as a predictor of gonorrhoea or chlamydia in asymptomatic Aboriginal males at the Central Australian Aboriginal Congress Male Clinic (Ingkintja), first-void urine samples and clinical information were collected from consecutive asymptomatic males presenting to the Ingkintja in Alice Springs between March 2008 and December 2009. Urine was tested immediately with a leucocyte esterase test dipstick and then by polymerase chain reaction for gonorrhoea and chlamydia. Among the 292 specimens from asymptomatic males, 15.4% were positive for gonorrhoea or chlamydia. In this group, compared with polymerase chain reaction result for gonorrhoea or chlamydia, leucocyte esterase test alone and in combination with age ≤35 years showed sensitivities of 66.7% and 60%, specificities of 90.7% and 94.7%, positive predictive values of 56.6% and 67.5%, negative predictive values of 93.7% and 92.8% and the area under receiver operating characteristics curve values of 0.79 and 0.85, respectively. Leucocyte esterase tests can reasonably be used as a basis for immediate empirical treatment for gonorrhoea or chlamydia in asymptomatic central Australian Aboriginal men under 35 years of age.
authors: Collaborative Research Network for Mental Health in Rural and Regional Communities, The University of New England, Armidale, Australia.
authors: Md Saifur
authors: MS
authors: Rahman
authors: Warwick
authors: W
authors: Beever
authors: Steven
authors: S
authors: Skov
authors: John
authors: J
authors: Boffa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002265:Carboxylic Ester Hydrolases / Q000652:urine*; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000208:ethnology / Q000652:urine; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D006069:Gonorrhea / Q000175:diagnosis* / Q000652:urine; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011320:Primary Health Care; D011934:Reagent Strips; D019035:Rural Health Services; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D011934:Reagent Strips; C021443:leukocyte esterase; D002265:Carboxylic Ester Hydrolases
keywords: Aboriginal; STIs; Sexually transmitted infections; asymptomatic; chlamydia; diagnosis; gonorrhoea; leucocyte esterase test; men; screening; sensitivity; specificity; syndromic management; urine