ArticleSexually transmitted infections2014
Evaluation of WHO screening algorithm for the presumptive treatment of asymptomatic rectal gonorrhoea and chlamydia infections in at-risk MSM in Kenya.
Article in Sexually transmitted infections, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Prevalence of genital and anorectal chlamydia trachomatis in Kenya by risk groups: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Prevalence of gonococcal and chlamydial infections among men who have sex with men in sub-Saharan Africa: a systematic review and meta-analysis.Systematic reviews · 2024Pooled it
- Gonorrhoea: a systematic review of prevalence reporting globally.BMC infectious diseases · 2021Pooled it
- Emerging themes for sensitivity training modules of African healthcare workers attending to men who have sex with men: a systematic review.International health · 2015Pooled it
- World Health Organization-Recommended Periodic Presumptive Treatment Versus Doxycycline Post-Exposure Prophylaxis for Sexually Transmitted Infection Control Among Men Who Have Sex With Men in Kenya: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2026Article
- Sexually transmitted enteric infections in men who have sex with men.Clinical microbiology reviews · 2025Review
- Article
- Sexually transmitted infection screening, prevalence and incidence among South African men and transgender women who have sex with men enrolled in a combination HIV prevention cohort study: the Sibanye Methods for Prevention Packages Programme (MP3) project.Journal of the International AIDS Society · 2020Article
- Prevalence and correlates of and a risk score to identify asymptomatic anorectal gonorrhoea and chlamydia infection among men who have sex with men in Kisumu, Kenya.Sexually transmitted infections · 2019Article
- Rectal gonorrhoea and chlamydia among men who have sex with men in coastal Kenya.Wellcome open research · 2019Article
- Depressive symptoms and problematic alcohol and other substance use in 1476 gay, bisexual, and other MSM at three research sites in Kenya.AIDS (London, England) · 2018Article
- Sexual partner characteristics and incident rectalSexually transmitted infections · 2017Article
- Article
- Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A Review of the Literature.Infectious diseases in obstetrics and gynecology · 2016Review
- Kenyan MSM: no longer a hidden population.AIDS (London, England) · 2015Article
- Strengthening healthcare providers' skills to improve HIV services for MSM in Kenya.AIDS (London, England) · 2015Article
- A Cross Sectional Analysis of Gonococcal and Chlamydial Infections among Men-Who-Have-Sex-with-Men in Cape Town, South Africa.PloS one · 2015Article
- High Prevalence of Asymptomatic Sexually Transmitted Infections among Men Who Have Sex with Men.Journal of clinical medicine · 2014Article
- High HIV seroprevalence, rectal STIs and risky sexual behaviour in men who have sex with men in Dar es Salaam and Tanga, Tanzania.BMJ open · 2014Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
Abstract
objectivesThe WHO recommends that men who have sex with men (MSM) reporting unprotected receptive anal intercourse (RAI) and either multiple partners or a partner with a sexually transmitted infection (STI) in the past 6 months should be presumptively treated for asymptomatic rectal Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections. We evaluated this recommendation in a cohort of 'high-risk' MSM in Coastal Kenya.
methodsWe assessed presence of genitourinary and rectal symptoms, and determined prevalence and 3-month incidence of rectal NG and CT infections. We performed nucleic acid amplification testing of urine and rectal swab samples collected from MSM followed prospectively, and assessed predictive values of the WHO algorithm at baseline screening.
resultsOf 244 MSM screened, 240 (98.4%) were asymptomatic, and 147 (61.3%) reported any RAI in the past 6 months. Among 85 (35.4%) asymptomatic MSM meeting criteria for the WHO presumptive treatment (PT) recommendation, we identified 20 with rectal infections (six NG, 12 CT and two NG-CT co-infections). Among 62 asymptomatic MSM who did not meet criteria, we identified seven who were infected. The sensitivity and specificity of the WHO algorithm were 74.1% (95% CI 53.7% to 88.9%) and 45.8% (95% CI 36.7% to 55.2%), respectively. The 3-month incidence of any rectal NG or CT infection in asymptomatic men reporting any RAI was 39.7 (95% CI 24.3 to 64.8) per 100 person-years.
conclusionsAbout one-third of asymptomatic MSM were eligible to receive PT for NG and CT infections. Among MSM who would qualify for PT of rectal STIs, the number needed to treat in order to treat one infection was four. Our results support the value of the WHO screening algorithm and recommended PT strategy in this population.
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