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

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. We recruited symptomatic male patients at public clinics, and used standardised questionnaires, examinations and laboratory tests. 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%). Most cases of syphilis were asymptomatic, supporting routine screening for syphilis. Urethral symptoms predicted infection with N. gonorrhoeae/C. trachomatis better than clinical signs.