Prevalence of Rectal Chlamydial and Gonococcal Infections: A Systematic Review

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Rectal infections caused by Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (Ng) are significant public health concerns.
• Understanding the prevalence of these sexually transmitted infections (STIs) in various populations and settings is crucial for effective control strategies.

Purpose of the Study:

• To systematically review and synthesize the available English-language literature on the prevalence of rectal Ct and Ng infections.
• To examine prevalence data across different demographic groups, including men who have sex with men (MSM) and women, and across various clinical settings.

Main Methods:

• A systematic literature search was conducted across multiple electronic databases.
• Inclusion criteria focused on English-language publications reporting rectal Ct or Ng prevalence determined by nucleic acid amplification tests.
• Data from 115 eligible studies published between January 2000 and November 2016 were analyzed.

Main Results:

• The overall prevalence of rectal Ct was 9%, higher than that of rectal Ng at 4.7%.
• Rectal Ct prevalence was similar in MSM (9%) and women (9.2%).
• Rectal Ng prevalence was higher in MSM (6.1%) compared to women (1.7%).
• Rectal Ct prevalence showed little variation between sexually transmitted disease (STD) clinics (9.1%) and non-STD clinics (8.6%).
• Rectal Ng prevalence was slightly lower in STD clinics (4.5%) than in non-STD clinics (6%).

Conclusions:

• Rectal Ct and Ng infections are relatively common in diverse populations and clinical settings.
• The findings highlight the importance of considering rectal STIs in screening and management protocols.
• Further research is warranted to develop and implement effective prevention and treatment strategies for these infections.