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High burden of chlamydia and gonorrhoea in pharyngeal, rectal and urethral sites among Thai transgender women: implications for anatomical site selection for the screening of STI.
Sex Transm Infect. 2019 11; 95(7):534-539.ST

Abstract

OBJECTIVE

Comprehensive data on Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections to guide screening services among transgender women (TGW) are limited. We studied the burden of CT/NG infections in pharyngeal, rectal and urethral sites of Thai TGW and determined missed CT/NG diagnoses if selected site screening was performed.

METHODS

Thai TGW were enrolled to the community-led test and treat cohort. CT/NG screening was performed from pharyngeal swab, rectal swab and urine using nucleic acid amplification test. CT/NG prevalence in each anatomical site was analysed, along with the relationships of CT/NG among the three anatomical sites.

RESULTS

Of 764 TGW included in the analysis, 232 (30.4%) had CT/NG infections at any anatomical site, with an overall incidence of 23.7 per 100 person-years. The most common CT/NG infections by anatomical site were rectal CT (19.5%), rectal NG (9.6%) and pharyngeal NG (8.1%). Among 232 TGW with CT/NG infections at any anatomical site, 22%-94.4% of infections would have been missed if single anatomical site testing was conducted, depending on the selected site. Among 668 TGW who tested negative at pharyngeal site, 20.4% had either rectal or urethral infections. Among 583 TGW who tested negative at the rectal site, 8.7% had either pharyngeal or urethral infections. Among 751 TGW who tested negative at the urethral site, 19.2% had either pharyngeal or rectal infections.

CONCLUSION

Almost one-third of Thai TGW had CT/NG infections. All-site screening is highly recommended to identify these infections, but if not feasible rectal screening provides the highest yield of CT/NG diagnoses. Affordable molecular technologies and/or CT/NG screening in pooled samples from different anatomical sites are urgently needed.

TRIAL REGISTRATION NUMBER

NCT03580512.

Links

Publisher Full Text

Authors+Show Affiliations

Hiransuthikul A

PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand ahiransuthikul@gmail.com.

Janamnuaysook R

PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.

PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.

PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.

PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.

LINKAGES Thailand FHI 360, Bangkok, Thailand.

Office of Public Health, US Agency for International Development, Bangkok, Thailand.

PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.

PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.

MeSH

AdolescentAdultAsian Continental Ancestry GroupChlamydiaChlamydia InfectionsFemaleGonorrheaHumansMaleMass ScreeningMiddle AgedNeisseria gonorrhoeaePharynxPrevalenceRectumThailandTransgender PersonsUrethraYoung Adult

Pub Type(s)

Journal Article

Research Support, Non-U.S. Gov't

Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

30982000

Clinical Trial Links

Clinical trial which this article describes

Citation

Hiransuthikul, Akarin, et al. "High Burden of Chlamydia and Gonorrhoea in Pharyngeal, Rectal and Urethral Sites Among Thai Transgender Women: Implications for Anatomical Site Selection for the Screening of STI." Sexually Transmitted Infections, vol. 95, no. 7, 2019, pp. 534-539.

Hiransuthikul A, Janamnuaysook R, Sungsing T, et al. High burden of chlamydia and gonorrhoea in pharyngeal, rectal and urethral sites among Thai transgender women: implications for anatomical site selection for the screening of STI. Sex Transm Infect. 2019;95(7):534-539.

Hiransuthikul, A., Janamnuaysook, R., Sungsing, T., Jantarapakde, J., Trachunthong, D., Mills, S., Vannakit, R., Phanuphak, P., & Phanuphak, N. (2019). High burden of chlamydia and gonorrhoea in pharyngeal, rectal and urethral sites among Thai transgender women: implications for anatomical site selection for the screening of STI. Sexually Transmitted Infections, 95(7), 534-539. https://doi.org/10.1136/sextrans-2018-053835

Hiransuthikul A, et al. High Burden of Chlamydia and Gonorrhoea in Pharyngeal, Rectal and Urethral Sites Among Thai Transgender Women: Implications for Anatomical Site Selection for the Screening of STI. Sex Transm Infect. 2019;95(7):534-539. PubMed PMID: 30982000.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - High burden of chlamydia and gonorrhoea in pharyngeal, rectal and urethral sites among Thai transgender women: implications for anatomical site selection for the screening of STI. AU - Hiransuthikul,Akarin, AU - Janamnuaysook,Rena, AU - Sungsing,Thanthip, AU - Jantarapakde,Jureeporn, AU - Trachunthong,Deondara, AU - Mills,Steve, AU - Vannakit,Ravipa, AU - Phanuphak,Praphan, AU - Phanuphak,Nittaya, Y1 - 2019/04/13/ PY - 2018/09/07/received PY - 2019/03/16/revised PY - 2019/04/02/accepted PY - 2019/4/15/pubmed PY - 2020/2/13/medline PY - 2019/4/15/entrez KW - chlamydia trachomatis KW - hiv KW - neisseria gonorrhoea KW - transsexual SP - 534 EP - 539 JF - Sexually transmitted infections JO - Sex Transm Infect VL - 95 IS - 7 N2 - OBJECTIVE: Comprehensive data on Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections to guide screening services among transgender women (TGW) are limited. We studied the burden of CT/NG infections in pharyngeal, rectal and urethral sites of Thai TGW and determined missed CT/NG diagnoses if selected site screening was performed. METHODS: Thai TGW were enrolled to the community-led test and treat cohort. CT/NG screening was performed from pharyngeal swab, rectal swab and urine using nucleic acid amplification test. CT/NG prevalence in each anatomical site was analysed, along with the relationships of CT/NG among the three anatomical sites. RESULTS: Of 764 TGW included in the analysis, 232 (30.4%) had CT/NG infections at any anatomical site, with an overall incidence of 23.7 per 100 person-years. The most common CT/NG infections by anatomical site were rectal CT (19.5%), rectal NG (9.6%) and pharyngeal NG (8.1%). Among 232 TGW with CT/NG infections at any anatomical site, 22%-94.4% of infections would have been missed if single anatomical site testing was conducted, depending on the selected site. Among 668 TGW who tested negative at pharyngeal site, 20.4% had either rectal or urethral infections. Among 583 TGW who tested negative at the rectal site, 8.7% had either pharyngeal or urethral infections. Among 751 TGW who tested negative at the urethral site, 19.2% had either pharyngeal or rectal infections. CONCLUSION: Almost one-third of Thai TGW had CT/NG infections. All-site screening is highly recommended to identify these infections, but if not feasible rectal screening provides the highest yield of CT/NG diagnoses. Affordable molecular technologies and/or CT/NG screening in pooled samples from different anatomical sites are urgently needed. TRIAL REGISTRATION NUMBER: NCT03580512. SN - 1472-3263 UR - https://www.unboundmedicine.com/medline/citation/30982000/High_burden_of_chlamydia_and_gonorrhoea_in_pharyngeal_rectal_and_urethral_sites_among_Thai_transgender_women:_implications_for_anatomical_site_selection_for_the_screening_of_STI_ L2 - https://sti.bmj.com/lookup/pmidlookup?view=long&pmid=30982000 DB - PRIME DP - Unbound Medicine ER -