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Clinical presentation of asymptomatic and symptomatic heterosexual men who tested positive for urethral gonorrhoea at a sexual health clinic in Melbourne, Australia.
BMC Infect Dis. 2020 Jul 08; 20(1):486.BI

Abstract

BACKGROUND

Asymptomatic screening for gonorrhoea in heterosexual men is currently not recommended in many countries including Australia, given the prevalence is relatively low in the heterosexual population. We aimed to determine the proportion of urethral gonorrhoea cases among heterosexual men attending a sexual health clinic that was asymptomatic and symptomatic, the time since last sexual contact to the onset of symptoms and the time to clinic presentation following the onset of symptoms.

METHODS

This was a cross-sectional study that included heterosexual men aged 16 years or above attending the Melbourne Sexual Health Centre (MSHC) in Australia between August 2017 and August 2018. Gonorrhoea cases were diagnosed by nucleic acid amplification testing (NAAT) and/or culture. Descriptive analyses were conducted for all gonorrhoea cases including demographic characteristics, recent sexual practices, reported urethral symptoms and duration, sexual contact with a person diagnosed with gonorrhoea, investigations performed and laboratory results.

RESULTS

There were 116 confirmed cases of urethral gonorrhoea in heterosexual men over the study period of which 6.0% (95% CI: 2.7-12.1%) were asymptomatic. Typical urethral discharge was present in 80.2% (95% CI: 71.9-86.5%) of men. The mean time between last sexual contact and the onset of symptoms was 7.0 days, and between the onset of symptoms to presentation to the clinic was 5.6 days.

CONCLUSIONS

A small proportion of heterosexual men with urethral gonorrhoea do not have any symptoms. Heterosexual men with urethral symptoms usually seek for healthcare within a week, prompting rapid healthcare-seeking behaviour.

Authors+Show Affiliations

Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia. martinsanchezmario@gmail.com. Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Barcelona, Spain. martinsanchezmario@gmail.com. Public Health Agency of Barcelona, Plaça de Lesseps, 1, 08023, Barcelona, Spain. martinsanchezmario@gmail.com.Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia. Central Clinical School, Monash University, Melbourne, VIC, Australia.Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia. Central Clinical School, Monash University, Melbourne, VIC, Australia.Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia. Central Clinical School, Monash University, Melbourne, VIC, Australia.Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia.Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia. Central Clinical School, Monash University, Melbourne, VIC, Australia.Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia. Central Clinical School, Monash University, Melbourne, VIC, Australia.Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia. Central Clinical School, Monash University, Melbourne, VIC, Australia.Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Melbourne, VIC, 3053, Australia. echow@mshc.org.au. Central Clinical School, Monash University, Melbourne, VIC, Australia. echow@mshc.org.au. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia. echow@mshc.org.au.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32641070

Citation

Martín-Sánchez, Mario, et al. "Clinical Presentation of Asymptomatic and Symptomatic Heterosexual Men Who Tested Positive for Urethral Gonorrhoea at a Sexual Health Clinic in Melbourne, Australia." BMC Infectious Diseases, vol. 20, no. 1, 2020, p. 486.
Martín-Sánchez M, Ong JJ, Fairley CK, et al. Clinical presentation of asymptomatic and symptomatic heterosexual men who tested positive for urethral gonorrhoea at a sexual health clinic in Melbourne, Australia. BMC Infect Dis. 2020;20(1):486.
Martín-Sánchez, M., Ong, J. J., Fairley, C. K., Chen, M. Y., Williamson, D. A., Maddaford, K., Aung, E. T., Carter, G., Bradshaw, C. S., & Chow, E. P. F. (2020). Clinical presentation of asymptomatic and symptomatic heterosexual men who tested positive for urethral gonorrhoea at a sexual health clinic in Melbourne, Australia. BMC Infectious Diseases, 20(1), 486. https://doi.org/10.1186/s12879-020-05197-y
Martín-Sánchez M, et al. Clinical Presentation of Asymptomatic and Symptomatic Heterosexual Men Who Tested Positive for Urethral Gonorrhoea at a Sexual Health Clinic in Melbourne, Australia. BMC Infect Dis. 2020 Jul 8;20(1):486. PubMed PMID: 32641070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical presentation of asymptomatic and symptomatic heterosexual men who tested positive for urethral gonorrhoea at a sexual health clinic in Melbourne, Australia. AU - Martín-Sánchez,Mario, AU - Ong,Jason J, AU - Fairley,Christopher K, AU - Chen,Marcus Y, AU - Williamson,Deborah A, AU - Maddaford,Kate, AU - Aung,Ei T, AU - Carter,Georgia, AU - Bradshaw,Catriona S, AU - Chow,Eric P F, Y1 - 2020/07/08/ PY - 2020/05/14/received PY - 2020/06/24/accepted PY - 2020/7/10/entrez PY - 2020/7/10/pubmed PY - 2020/7/22/medline KW - Discharge KW - Genital KW - MSM KW - Men who have sex with women KW - Neisseria gonorrhoeae KW - Screening KW - Sexually transmitted infections KW - Testing KW - Urogenital SP - 486 EP - 486 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 20 IS - 1 N2 - BACKGROUND: Asymptomatic screening for gonorrhoea in heterosexual men is currently not recommended in many countries including Australia, given the prevalence is relatively low in the heterosexual population. We aimed to determine the proportion of urethral gonorrhoea cases among heterosexual men attending a sexual health clinic that was asymptomatic and symptomatic, the time since last sexual contact to the onset of symptoms and the time to clinic presentation following the onset of symptoms. METHODS: This was a cross-sectional study that included heterosexual men aged 16 years or above attending the Melbourne Sexual Health Centre (MSHC) in Australia between August 2017 and August 2018. Gonorrhoea cases were diagnosed by nucleic acid amplification testing (NAAT) and/or culture. Descriptive analyses were conducted for all gonorrhoea cases including demographic characteristics, recent sexual practices, reported urethral symptoms and duration, sexual contact with a person diagnosed with gonorrhoea, investigations performed and laboratory results. RESULTS: There were 116 confirmed cases of urethral gonorrhoea in heterosexual men over the study period of which 6.0% (95% CI: 2.7-12.1%) were asymptomatic. Typical urethral discharge was present in 80.2% (95% CI: 71.9-86.5%) of men. The mean time between last sexual contact and the onset of symptoms was 7.0 days, and between the onset of symptoms to presentation to the clinic was 5.6 days. CONCLUSIONS: A small proportion of heterosexual men with urethral gonorrhoea do not have any symptoms. Heterosexual men with urethral symptoms usually seek for healthcare within a week, prompting rapid healthcare-seeking behaviour. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/32641070/Clinical_presentation_of_asymptomatic_and_symptomatic_heterosexual_men_who_tested_positive_for_urethral_gonorrhoea_at_a_sexual_health_clinic_in_Melbourne,_Australia L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05197-y DB - PRIME DP - Unbound Medicine ER -