Urine-Based Screening of Adolescents in Detention to Guide Treatment for Gonococcal and Chlamydial Infections

Abstract

Objectives To determine the utility of urine-based ligase chain reaction assays forNeisseria gonorrhoeaeandChlamydia trachomatisin (1) the acceptability of such testing to adolescent detainees, (2) the potential use of these tests for identifying asymptomatic infections, and (3) the effectiveness of this approach for ensuring treatment of infected adolescents. Design Cross-sectional screening and verification of treatment for infected cases. Subjects Adolescents admitted to a short-term juvenile detention center. Main Outcome Measures Neisseria gonorrhoeaeandC trachomatisinfection rates, and timing and location of treatment for infected patients. Results Refusal rate was 1.5%. Of 263 participants, 46 (17.5%) were female subjects.Chlamydia trachomatisinfections were identified in 28.3% of the female and 8.8% of the male subjects.Neisseria gonorrhoeaeinfections were present in 13.1% of the female and 2.8% of the male subjects. Overall, 37 participants (14%) were positive forN gonorrhoeae,C trachomatis,or both, only one of whom had symptoms. Almost 70% (25/36) of asymptomatic infected subjects were treated within 28 days of screening. A treatment was documented in 36 of the 37 infected youth, including 20 who were followed up and treated after release from the detention center, by 6 months after testing. Conclusion Urine ligase chain reaction tests were effective for identifying and guiding treatment of unsuspectedN gonorrhoeaeandC trachomatisinfections in teenagers admitted to a short-term detention center where traditional swab specimens may be difficult to obtain.