title: Factors associated with the over-treatment and under-treatment of gonorrhea and chlamydia in adolescents presenting to a public hospital emergency department.
abstract: OBJECTIVE
  The purpose of this study was to measure the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) and the rates and factors associated with their over-treatment (OT) and under-treatment (UT).
  
  
  METHODS
  A retrospective chart review was performed of patients aged 13-24 years who were screened for GC/CT in the emergency department (ED) of a public hospital. Descriptive statistics were obtained for all variables, and multivariate log binomial regression was performed to ascertain the factors associated with OT and UT.
  
  
  RESULTS
  Seven hundred and ninety-seven adolescents and young adults were screened for GC/CT. The overall sexually transmitted infection (STI) positivity rate was 21.6%; 136 (21.6%) subjects were over-treated and 74 (43.4%) subjects were under-treated. Patients presenting with STI exposure or genito-urinary symptoms were more likely to be OT. Additionally, females aged 18-19 years or with a prior history of STIs were more likely to be OT. Females (83.6%) were more likely to be UT, while STI exposure, genito-urinary symptoms, and a prior history of STI were protective of UT .
  
  
  CONCLUSIONS
  Adolescents and young adults screened for STIs have a high prevalence of GC/CT. A significant proportion of these patients end up over-treated and an even higher proportion are under-treated.
authors: Department of Pediatrics (MC 856), The University of Illinois at Chicago, 840 S. Wood Street, Chicago, IL 60612, USA. Electronic address: mjanaene@gmail.com.
authors: Mutimbwa
authors: M
authors: Anaene
authors: Pediatric Emergency Room, John H. Stroger Hospital of Cook County, Chicago, Illinois, USA.
authors: Kenneth
authors: K
authors: Soyemi
authors: Department of Internal Medicine, The University of Illinois at Chicago, Chicago, Illinois, USA.
authors: Rachel
authors: R
authors: Caskey
mesh_terms: D000293:Adolescent; D002690:Chlamydia Infections / Q000188:drug therapy* / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D004636:Emergency Service, Hospital; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000453:epidemiology; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008403:Mass Screening; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D010372:Pediatrics; D015995:Prevalence; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
keywords: Adolescent; Chlamydia; Gonorrhea; Screening; Treatment