Prevalence of 3 sexually transmitted infections in a pediatric emergency department

Creator(s)

Melissa K. Miller, Children's Mercy HospitalFollow
M Denise Dowd, Children's Mercy HospitalFollow
Christopher J. Harrison, Children's Mercy HospitalFollow
Cynthia J. Mollen, The Children's Hospital of Philadelphia
Rangaraj Selvarangan, Children's Mercy HospitalFollow
Sharon Humiston, Children’s Mercy HospitalFollow

Document Type

Article

Publication Date

2-2015

Identifier

10.1097/PEC.0000000000000284; PMCID: PMC5004729

Abstract

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

OBJECTIVE: This study aimed to determine the prevalence of Chlamydia trachomatis, Neisseria gonorrheae, and Trichomonas vaginalis and to describe factors associated with sexually transmitted infection (STI) in a pediatric emergency department (ED).

METHODS: Adolescents aged 14 to 19 years presenting to a Midwestern pediatric ED were asked to provide urine for STI testing and complete a survey about previous sexual activity (PSA), high-risk behaviors, demographics, and visit reason (reproductive: genitourinary complaints, abdominal pain, or a female with vomiting). Comparisons between subgroups were analyzed using X test.

RESULTS: Among 200 subjects (64% of approached), mean age was 15.6 years; 63% were female. Eleven subjects (6%; 95% confidence interval, 2.3-8.7) tested positive for 1 or more STIs: 10 for C. trachomatis (one denied PSA), 3 for T. vaginalis (all coinfected with C. trachomatis), and 1 for N. gonorrheae. Half reported PSA; of these, 71% reported 1 or more high-risk behaviors, most commonly first sex before the age of 15 years (51%) and no condom at last sex (42%). Among those with PSA and nonreproductive visit (n = 73), 11.0% had 1 or more STIs (95% confidence interval, 3.4-18.1). Two factors were associated with greater likelihood of positive STI test result, namely, reporting PSA versus no PSA (10% vs 1%, P = 0.005) and last sex within 1 month or less versus more than 1 month (20% vs 0%, P = 0.001). In this sample, none of the following characteristics were associated with STI: insurance, race, high-risk behaviors, age, or ED visit reason.

CONCLUSIONS: Approximately 1 in 10 sexually active adolescent ED patients without reproductive complaints had 1 or more STIs. This suggests the need for strategies to increase STI testing for this population.

Journal Title

Pediatric Emergency Care

Volume

31

Issue

2

First Page

107

Last Page

112

Keywords

Adolescent health services, Prevalence, Sexually transmitted diseases

Comments

Grant support

• KL2 TR000119/TR/NCATS NIH HHS/United States
• TL1 TR000120/TR/NCATS NIH HHS/United States
• KL2TR000119-02/TR/NCATS NIH HHS/United States

Recommended Citation

Miller, M. K., Dowd, M. D., Harrison, C. J., Mollen, C. J., Selvarangan, R., Humiston, S. Prevalence of 3 sexually transmitted infections in a pediatric emergency department Pediatric Emergency Care 31, 107-112 (2015).