AN EVALUATION OF GONORRHEA CASE FINDING IN THE CHRONICALLY INFECTED FEMALE1

Abstract

Johnson, D. W. (Univ. of Oregon Medical School, Portland, Oregon 97201), K. K. Holmes, P. A. Kvale, C. W. Halverson and W. P. Hirsch. An evaluation of gonorrhea case finding in the chronically infected female. Amer. J. Epid., 1969, 90: 438–448.—Diagnosis of asymptomatic gonorrhea in the female is hampered by shortcomings in present isolation techniques. In a study among night club hostesses in the Philippines, the authors evaluated a bacteriologic loop technique for obtaining endocervical specimens which were inoculated on the selective culture medium of Thayer and Martin. Among 702 hostesses chosen at random, 8.5% were found infected at the first examination; however, on repeated weekly cultures the infection prevalence for the group cumulatively rose to 19.7%. Among 163 named contacts of American servicemen, 22% were found infected at the first examination, and the cumulative figure rose to 44.6% on repeated weekly cultures. Antibiotic preparations and vaginal cleansing done prior to examination apparently did not interfere with culture diagnosis. When dates of onset of the last memstrual periods were correlated with culture results, it was found that infections were most likely to be identified in pre-menstrual and menstrual flow days rather than during the mid-cycle.