![]() ![]() In contrast, selective testing is a suboptimal control strategy for anorectal chlamydia, as we found a high prevalence in women both with and without indication for anorectal testing, along with a substantial amount of anorectal-only infections. Rectal gonorrhea symptoms may develop 57 days after exposure and include mild anorectal pain, scant bleeding, pruritus, and mucopurulent discharge manifested. Selective testing on indication could be an appropriate control strategy for anorectal gonorrhea, as few infections would be missed. Anorectal screening in women without an indication is feasible and highly acceptable. For women with missing indication, this was 7% (n = 9)/8% (n = 1) and 44% (n = 4)/100% (n = 1).Conclusions. Of all anorectal chlamydia/gonorrhea cases, 72% (n = 92)/33% (n = 4) were diagnosed in women without an indication, of which 19% (n = 19)/0% (n = 0) were anorectal only. ![]() Self-reported anal sex and anal symptoms were independently associated with anorectal gonorrhea (odds ratios, 3.3 and 14.5, respectively), but not with anorectal chlamydia. Overall anorectal chlamydia/gonorrhea positivity was 13.4% (n = 127)/1.3% (n = 12). Of all women who visited our clinic, 94% (n = 950) participated in the study. Logistic regression analyses were used to identify determinants associated with anorectal chlamydia and gonorrhea. In total, 19.5% (n = 185) of women had an indication (reported anal sex or symptoms), 72.5% (n = 689) did not have an indication, and 8.0% (n = 76) had missing information on indication. All women (n = 1012) aged >= 16 years attending our sexually transmitted infection clinic in 2015 were offered routine universal screening. Little is known about the impact of another testing strategy, routine universal anorectal screening with respect to chlamydia and gonorrhea prevalence and risk factors. Testing on indication of self-reported anal sex or symptoms is used to manage anorectal Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhea) infections in women. ![]()
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