The value of urine specimens in screening for male urethritis and its microbial aetiologies in Tanzania.

Mayaud, Philippe; Changalucha, John; Grosskurth, Heiner; ka-Gina, G; Rugemalila, J; Nduba, J; Newell, James; Hayes, Richard; Mabey, David

doi:10.1136/sti.68.6.361

Cited by 16 publications

(9 citation statements)

References 21 publications

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“…10 Mayaud et al 30 and Sellors et al 12 reported that the cost per case detected using LET dipstick to pre-screen urine specimens was relatively inexpensive compared with the strategy that would test every urine specimen with a diagnostic test. However, as Bowden observed, the social and economic costs of the sequelae of untreated STIs such as infertility are high with the hospital treatment of one case possibly outweighing those saved by screening with LET before definitive testing.…”

Section: Discussionmentioning

confidence: 99%

Using urinary leucocyte esterase tests as an indicator of infection with gonorrhoea or chlamydia in asymptomatic males in a primary health care setting

Rahman

Beever²,

Skov

et al. 2013

Int J STD AIDS

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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.

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Section: Discussionmentioning

confidence: 99%

Using urinary leucocyte esterase tests as an indicator of infection with gonorrhoea or chlamydia in asymptomatic males in a primary health care setting

Rahman

Beever²,

Skov

et al. 2013

Int J STD AIDS

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“…We previously evaluated this test in 151 medical outpatients without urethral discharge at a Mwanza hospital17 and found that 22 (15%) had a positive result. Of these, seven were found to have N gonorrhoeae or C trachomatis infection, or both, giving a positive predictive value of 32% in this outpatient group, similar to the 27% recorded in the general population in the present study.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic gonorrhoea and chlamydial infection in rural Tanzanian men

Grosskurth

Mayaud²,

Mosha³

et al. 1996

BMJ

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Objective-To measure the prevalence of urethritis due to Neisseria gonorrhoeae and Chlamydia trachomatis in rural Tanzanian men.Design-About 500 men aged 15-54 years were selected from each of 12 rural communities by random cluster sampling; interviewed concerning past or present symptoms of sexually transmitted diseases; and asked to provide a first catch urine specimen, which was tested for pyuria with a leucocyte esterase dipstick test. Subjects with symptoms or with a positive result on testing were examined, and urethral swabs were taken for detection of N gonorrhoeae by gram stain and of C trachomatis by antigen detection immunoassay.Setting-Mwanza region, north westernTanzania.

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“…Furthermore, studies of the aetiology of urethritis in sub-Saharan Africa have usually focused on chlamydial and gonococcal urethritis. [6][7][8] There is little information on the prevalence of Trichomonas vaginalis infection in men in this region although trichomoniasis is known to be one of the most prevalent STDs in women, 9 10 and in one study trichomoniasis was associated with an increased risk of HIV transmission. 3 In male Kenyan transport workers trichomoniasis was more prevalent than either gonococcal or chlamydia urethritis (6.0% v 3.4% and 3.6% respectively) and 83% of T vaginalis infections were asymptomatic.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of trichomoniasis in rural men in Mwanza, Tanzania: results from a population based study

Watson-Jones

Mugeye²,

Mayaud³

et al. 2000

Sexually Transmitted Infections

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Objectives:To measure the prevalence of urethral infections including trichomoniasis in rural Tanzanian men, to assess the prevalence of symptoms and signs among men with Trichomonas vaginalis, and to analyse the risk factors for trichomoniasis. Design: A cross sectional study of 1004 men aged 15-54 years in a rural community in north west Tanzania. Methods: Participants were interviewed about sexual behaviour and symptoms of sexually transmitted diseases. First fraction urine samples and urethral swabs were collected and used to test for T vaginalis by wet preparation and culture, Neisseria gonorrhoeae by culture, Chlamydia trachomatis by ligase chain reaction and non-specific urethritis by Gram stain. Urine was also tested for the presence of leucocytes using a leucocyte esterase dipstick. Men were re-interviewed 2 weeks later to document new symptoms and signs of urethritis. Results: Complete laboratory results were available on 980 men. One in four men had laboratory evidence of urethritis. T vaginalis was found in 109 individuals (11%), gonorrhoea in eight (0.8%), and chlamydial infection in 15 (1.5%). Over 50% of men with urethritis were asymptomatic. The prevalence of signs and symptoms was similar among men with T vaginalis alone compared with men with other urethral infections. The sensitivity and specificity of the leucocyte esterase dipstick (LED) test for detecting T vaginalis were 80% and 48% respectively in symptomatic men and 60% and 68% in asymptomatic men. Factors associated with trichomoniasis included religion, type of employment, and marital status. Conclusions: A high prevalence of urethritis was found in men in this community based study. More than half of the urethral infections detected were asymptomatic. The most prevalent pathogen was T vaginalis. Studies are needed on the prevalence of trichomoniasis in men presenting to health services with complaints suggestive of urethritis since treatment for T vaginalis is not included in the syndromic management of urethritis in most countries. The performance of the LED test as a screening test for trichomoniasis was unsatisfactory in both symptomatic and asymptomatic men. Improved screening tests are urgently needed to identify urethral infections that are asymptomatic and which are not covered by current syndromic management algorithms. (Sex Transm Inf 2000;76:355-362)

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The value of urine specimens in screening for male urethritis and its microbial aetiologies in Tanzania.

Cited by 16 publications

References 21 publications

Using urinary leucocyte esterase tests as an indicator of infection with gonorrhoea or chlamydia in asymptomatic males in a primary health care setting

Using urinary leucocyte esterase tests as an indicator of infection with gonorrhoea or chlamydia in asymptomatic males in a primary health care setting

Asymptomatic gonorrhoea and chlamydial infection in rural Tanzanian men

High prevalence of trichomoniasis in rural men in Mwanza, Tanzania: results from a population based study

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