Prevalence of sexually transmissible infections (STI) among male patients with STI in Denpasar and Makassar, Indonesia: are symptoms of urethritis sufficient to guide syndromic treatment?
Stephen C. Davies A D E , Baedah Madjid B , Sutaryo Pardohudoyo A , Anak Agung G. P. Wiraguna C , Jane H. Patten A and Luh Putu Upadisari AA Indonesia HIV/AIDS and STD Prevention and Care Project, Jakarta, Java, Indonesia.
B Department of Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.
C Department of Dematovenereology, Sanglah Hospital, Denpasar, Bali, Indonesia.
D Present address: Sexual Health Service, Royal North Shore Hospital, St Leonards, NSW 2065, Australia.
E Corresponding author. Email: sdavies@nsccahs.health.nsw.gov.au
Sexual Health 4(3) 213-215 https://doi.org/10.1071/SH07017
Submitted: 14 March 2007 Accepted: 9 July 2007 Published: 23 August 2007
Abstract
Background: There are few data on sexually transmissible infections in men in Indonesia. We conducted a prevalence study and compared symptoms alone with clinical signs to manage urethritis. Methods: We recruited symptomatic male patients at public clinics, and used standardised questionnaires, examinations and laboratory tests. Results: We recruited 273 men and the prevalences were Neisseria gonorrhoeae 18.2%, Chlamydia trachomatis 10.1%, and positive syphilis serology 5.2%. Four cases of HIV were detected. Urethral symptoms detected 91.7% of N. gonorrhoeae and/or C. trachomatis, and positive predictive value (PPV) was 41.8%, compared with clinical confirmation (sensitivity 86.1%, PPV 37.6%). Conclusions: Most cases of syphilis were asymptomatic, supporting routine screening for syphilis. Urethral symptoms predicted infection with N. gonorrhoeae/C. trachomatis better than clinical signs.
Additional keywords: chlamydia, diagnostic algorithms.
Acknowledgements
This study was funded by the Australian Agency for International Development (AusAID), through The Indonesia HIV/AIDS and STD Prevention and Care Project. The views presented in this paper do not necessarily reflect the views or policies of AusAID. The authors thank health authorities in Indonesia for granting permission to undertake this study, particularly the National and Provincial AIDS Commissions. We are grateful to the staff of the dermatovenereology clinics in Sanglah Hospital, Wangaya Hospital, Dr Wahidin Sudirohusodo Hospital and Labuang Baji Hospital, the staff of the Provincial Health Laboratory (BLK) in Makassar, Dr Endang Seyaningsih and S Sugianingsih at the National Institute of Health Research and Development in Jakarta, Dr M Lesmana and Dr Kevin Porter of NAMRU-2, K Wijaya, Sari Puspitawati of the Indonesia HIV/AIDS and STD Prevention and Care Project, and Dr Aboage-Kwarteng of Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia.
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