Correlates of time to clinical presentation for symptomatic individuals with gonorrhoea in South China: results from a cross-sectional study

BMJ Open. 2022 Mar 4;12(3):e052586. doi: 10.1136/bmjopen-2021-052586.


Objectives: This study aimed to determine the variation in the interval between the onset of symptoms and clinical presentation, and its associated factors among symptomatic individuals with gonorrhoea.

Design: A cross-sectional study was conducted between 1 June and 30 July 2017.

Setting: 129 sexually transmitted disease clinics from 21 cities of Guangdong, China.

Participants: Using convenience sampling method to recruit symptomatic individuals with gonorrhoea over 18 years old.

Outcome measure: Time to clinical presentation.

Results: Among 1664 participants, the median age was 29 (24-36) years old, and the majority were male (92.5%) and married (52.9%). The median time to clinical presentation was 3 (2-6) days. About 471 (28.3%) patients had sexual contact while symptomatic. After adjusting for covariates, participants who were female (aβ=0.44, 95% CI: 0.22 to 0.80), from east Guangdong region (aβ=0.44, 95% CI: 0.22 to 0.80) and had the absence of dysuria (aβ=0.26, 95% CI: 0.06 to 0.46) had increased time to clinical presentation. Participants who had commercial sex in the past 6 months (aβ=-0.11, 95% CI: -0.21 to -0.01) had decreased time to clinical presentation. Participants who were female (adjusted odds ratio (aOR)=1.66, 95% CI: 1.08 to 2.50) and delayed in seeking healthcare more than 7 days (aOR=46.71, 95% CI: 24.27 to 89.93) were more likely to have sexual contact while symptomatic.

Conclusion: The time to clinical presentation for individuals with symptomatic gonorrhoea is variable and a high proportion of participants continued to have sexual behaviour while symptomatic. Strategies to increase health literacy may help to minimise the sequelae of gonorrhoea and reduce onward transmission.

Keywords: gonorrhea; healthcare; symptomatic; time to clinical presentation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • China / epidemiology
  • Cross-Sectional Studies
  • Female
  • Gonorrhea* / diagnosis
  • Gonorrhea* / epidemiology
  • Humans
  • Male
  • Sex Work
  • Sexual Behavior
  • Young Adult