Prevalence and Factors Associated With Gonorrhea and Chlamydial Infection in At-Risk Females Presenting to an Urban Emergency Department

Abstract

Background Patients without a regular healthcare source are less likely to be tested, diagnosed, and treated effectively for sexually transmitted diseases (STDs). Emergency departments (EDs) are a major healthcare source for patients without health insurance or primary care providers. Goal This study evaluated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in women aged 15 to 35 years presenting to a metropolitan ED with genitourinary or pregnancy-related complaints and the frequency with which patients were effectively treated for these infections during routine ED care. Study Design Women completed an interviewer-administered questionnaire and submitted urine for ligase chain reaction (LCR) testing for C trachomatis and N gonorrhoeae. Results The combined prevalence of gonorrhea and chlamydia was 16.4% (n = 62), and factors associated with infection included younger age and greater numbers of sex partners over 30 days. Problem-oriented care failed to detect infection in most cases, and 58% of infected women left the ED without effective therapy. Through a close working relationship with the local health department, we documented that 92% had received effective follow-up therapy. Conclusion Continued efforts to refine and develop tools for the diagnosis and management of cervical infections for at-risk women seen in EDs are warranted.