URINE-BASED SCREENING OF ADOLESCENTS IN DETENTION TO GUIDE TREATMENT FOR GONOCOCCAL AND CHLAMYDIAL INFECTIONS - TRANSLATING RESEARCH INTO INTERVENTION

Objectives: To determine the utility of urine-based ligase chain react ion assays for Neisseria gonorrhoeae and Chlamydia trachomatis in (1) the acceptability of such testing to adolescent detainees, (2) the pot ential use of these tests for identifying asymptomatic infections, and (3) the effectiveness of this approach for ensuring treatment of infe cted adolescents. Design: Cross-sectional screening and verification o f treatment for infected cases. Subjects: Adolescents admitted to a sh ort-term juvenile detention center. Main Outcome Measures: Neisseria g onorrhoeae and C trachomatis infection rates, and timing and location of treatment for infected patients. Results: Refusal rate was 1.5%. Of 263 participants, 46 (17.5%) were female subjects. Chlamydia trachoma tis infections were identified in 28.3% of the female and 8.8% of the male subjects. Neisseria gonorrhoeae infections were present in 13.1% of the female and 2.8% of the male subjects. Overall, 37 participants (14%) were positive for N gonorrhoeae, C trachomatis, or both, only on e of whom had symptoms. Almost 70% (25/36) of asymptomatic infected su bjects were treated within 28 days of screening. A treatment was docum ented in 36 of the 37 infected youth, including 20 who were followed u p and treated after release from the detention center, by 6 months aft er testing. Conclusion: Urine ligase chain reaction tests were effecti ve for identifying and guiding treatment of unsuspected N gonorrhoeae and C trachomatis infections in teenagers admitted to a short-term det ention center where traditional swab specimens may be difficult to obt ain.