Gonorrhea detection in a family planning clinic: a cost-benefit analysis of 2,000 triplicate cultures

Among 2,019 women screened by triplicate culture technique, 191 (9.5 per cent) had one or more positive cultures of specimens for Neisseria gonorrhoeae. The prevalence rates by site of infection were as follows: cervix-8.1 per cent; rectum-2.4 per cent, and oropharynx-0.9 per cent. Of the 191 patients with gonorrhea, 163 (85 per cent) had a positive culture of the cervical specimen. Addition of routine cultures of rectal and oropharyngeal specimens detected only 15 per cent of positive cases, while tripling the cost of the screening program. Based on a cost-benefit anallysis, a culture of the cervical specimen is most appropriate for routine screening, and cultures of rectal and/or oropharyngeal specimens should be obtained on a selected basic only.