ArticleSexually transmitted diseases2026
Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae Among Adolescents and Adults With Behavioral Vulnerability in Western Kenya.
Article in Sexually transmitted diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundKenyan guidelines recommend syndromic management for sexually transmitted infections (STIs), which may miss many infections. We used nucleic acid amplification testing to screen for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) at 3 anatomic sites among adolescents and adults with behavioral risk factors in Western Kenya.
methodsFrom December 2021 to April 2023, we enrolled participants without HIV who were aged 14 to 55 years and reported a recent history of an STI, transactional sex, condomless sex with multiple partners, injection drug use, and/or anal sex with male partners. Urine, oropharyngeal swabs, and anorectal swabs were tested using Xpert CT/NG (Cepheid). Multivariable robust Poisson regression models were used to estimate prevalence ratios and 95% confidence intervals for factors potentially associated with the prevalence of both STIs combined.
resultsAmong 405 participants tested for CT/NG at enrollment, 324 (80.0%) were females, and 324 (80.0%) were aged 14 to 24 years. CT and/or NG was diagnosed in 143 participants (35.3%), including CT in 111 (27.4%) and NG in 76 (18.8%). Infections were most prevalent at the urogenital site, with 124 (30.6%) participants diagnosed with urogenital CT and/or NG. Anorectal CT/NG was observed in 117 (28.9%) and oropharyngeal CT/NG in 14 (3.5%). Females had higher prevalences than males of both urogenital (33.6% vs. 18.5%, P = 0.012) and anorectal CT/NG (31.8% vs. 17.3%, P = 0.015). A theoretical screening approach that only tested for urogenital infections would have missed 18.0% of CT cases and 18.4% of NG cases. In multivariable analyses, there were no statistically significant associations between sociodemographic variables and CT/NG prevalence.
conclusionsUrogenital and anorectal CT/NG infections were common in 2 communities in Western Kenya with behavioral vulnerability but difficult to predict based on sociodemographic variables. Nucleic acid amplification testing-based urogenital and anorectal screening of sexually active adolescents and young adults could reduce CT/NG burden in this population.
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