Detection of chlamydial and gonococcal urethral infection during jail intake: development of a screening algorithm

To determine risk factors for chlamydial or gonococcal urethral infection among adult male detainees at Cook County Jail. To develop a screening algorithm with high sensitivity and specificity for detection of urethral infection.

We interviewed adult male detainees and tested them for chlamydial or gonococcal urethral infection during jail intake from June 24 through July 29, 2004. We supplemented the cross-sectional survey with a nested case-control study.

We screened 5,634 (93%) of 6,028 detainees; 348 (6.2%) had chlamydial or gonococcal urethral infection. Interviews were completed and collected for 35%. By multivariable analysis, infected detainees were more likely to be <31 years of age, have more than 6 sex partners in the previous 12 months, or have symptoms. Age less than 31 years or symptoms would have identified 73% of infected detainees while screening only 50%.

A simple algorithm that included age and symptoms best identified detainees at increased risk for chlamydial or gonococcal urethral infection.