Prevalence and factors associated with gonorrhea and chlamydial infection in at-risk females presenting to an urban emergency department

Sex Transm Dis. 2003 Apr;30(4):335-9. doi: 10.1097/00007435-200304000-00012.


Background: Patients without a regular healthcare source are less likely to be tested, diagnosed, and treated effectively for sexually transmitted diseases (STDs). Emergency departments (EDs) are a major healthcare source for patients without health insurance or primary care providers.

Goal: This study evaluated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in women aged 15 to 35 years presenting to a metropolitan ED with genitourinary or pregnancy-related complaints and the frequency with which patients were effectively treated for these infections during routine ED care.

Study design: Women completed an interviewer-administered questionnaire and submitted urine for ligase chain reaction (LCR) testing for C trachomatis and N gonorrhoeae.

Results: The combined prevalence of gonorrhea and chlamydia was 16.4% (n = 62), and factors associated with infection included younger age and greater numbers of sex partners over 30 days. Problem-oriented care failed to detect infection in most cases, and 58% of infected women left the ED without effective therapy. Through a close working relationship with the local health department, we documented that 92% had received effective follow-up therapy.

Conclusion: Continued efforts to refine and develop tools for the diagnosis and management of cervical infections for at-risk women seen in EDs are warranted.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Alabama / epidemiology
  • Chlamydia Infections / epidemiology*
  • Chlamydia Infections / etiology
  • Chlamydia Infections / prevention & control*
  • Chlamydia trachomatis / isolation & purification
  • Delivery of Health Care
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Gonorrhea / epidemiology*
  • Gonorrhea / etiology
  • Gonorrhea / prevention & control*
  • Humans
  • Neisseria gonorrhoeae / isolation & purification
  • Outcome Assessment, Health Care
  • Prevalence
  • Risk Factors
  • Sexual Partners
  • Surveys and Questionnaires
  • Urban Health