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?

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.

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