Family Physician, Department of Social Medicine, Khon Kaen Center Hospital, Khon Kaen Province, Thailand.
Gynecologic Oncologist, Department of Obstetrics and Gynecology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Thailand.
PLoS One. 2019 Apr 3;14(4):e0211682. doi: 10.1371/journal.pone.0211682. eCollection 2019.
Gonorrhea (GC) infection caused by Neisseria gonorrhoeae has been steadily increasing in Thailand over the last decade. Men who have sex with men (MSM) are at high risk for gonorrhea infection.
In this study, we determined the prevalence of and risk factors associated with gonococcal infections by three anatomical sites among MSM. We have conducted a cross-sectional analysis of a sexually transmitted disease (STD), gonorrhea among MSM attending two STD clinics in Khon Kaen, Thailand. We included 358 MSM over 18 years of age. Data were collected using self-administered questionnaire. In each participant, an oropharyngeal, anorectal, and endourethral swab were tested with culture and nucleic acid amplification test (NAAT). However, 267 urine samples were tested by both methods. Factors associated with gonorrhea infections were assessed using univariate and multivariate logistic regression.
One hundred and ninety-five out of 358 (54.47%) MSM tested were found to be positive for gonorrhea using a porA gene targeted NAAT by Real-time PCR with TaqMan probes, but there was no positive result by culture. The gonorrheal prevalence for male genital site, anal, and oropharyngeal, were 34.73% (95%CI 33.07, 45.08), 29.01% (95%CI 24.61, 34.33), and 27.93% (95%CI 23.35, 32.89), respectively, while 5.9% (21/355) were positive for gonococcal infection in all anatomic sites (oropharynx + anus + urethra) of one participant. Previous history of diagnosed STDs was a significant factor associated urethral gonorrhea (odds ratio = 3.52, 95%CI 1.87-6.66, P Value< 0.001). In addition, having more than one partner was increased urethral gonorrhea (adjusted odds ratio = 2.26, 95%CI 1.10-4.68, P Value = 0.026). 100% of condom use was found decreasing urethral infection (adjusted odds ratio = 0.39, 95%CI 0.15-0.99, P Value = 0.046).
The most common anatomic site of gonorrhea infection was male genital site, and the independent risk factors were having history of diagnosed STDs and having more than one partner in the past 3 months, but 100% condom use was a protective factor of this infection.
在过去的十年中，泰国淋病（GC）感染人数稳步上升。男男性行为者（MSM）感染淋病的风险很高。
本研究通过对 MSM 三个解剖部位的淋球菌感染，确定了感染的流行率和相关风险因素。我们对泰国孔敬的两家性传播疾病（STD）诊所就诊的 MSM 进行了一项 STD-淋病的横断面分析。我们纳入了 358 名年龄在 18 岁以上的 MSM。数据通过自我管理问卷收集。对每个参与者进行口腔咽、肛门直肠和尿道内拭子培养和核酸扩增试验（NAAT）。然而，有 267 份尿液样本通过两种方法进行了检测。使用单变量和多变量逻辑回归评估与淋病感染相关的因素。
使用 TaqMan 探针实时 PCR 对 porA 基因靶向的 NAAT 进行检测，发现 358 名 MSM 中有 195 名（54.47%）呈淋病阳性，但培养无阳性结果。男性生殖器部位、肛门和口腔咽部的淋病患病率分别为 34.73%（95%CI 33.07, 45.08）、29.01%（95%CI 24.61, 34.33）和 27.93%（95%CI 23.35, 32.89），而在一个参与者的所有解剖部位（口腔咽+肛门+尿道）中，有 5.9%（21/355）的淋病感染呈阳性。以前诊断过的 STD 病史是与尿道淋病相关的显著因素（比值比=3.52，95%CI 1.87-6.66，P 值<0.001）。此外，有多个性伴侣会增加尿道淋病的发病率（调整后的比值比=2.26，95%CI 1.10-4.68，P 值=0.026）。100%使用安全套可降低尿道感染的发病率（调整后的比值比=0.39，95%CI 0.15-0.99，P 值=0.046）。
淋病感染最常见的解剖部位是男性生殖器部位，独立的危险因素是过去有诊断过的 STD 病史和过去 3 个月内有多个性伴侣，但是 100%使用安全套是这种感染的保护因素。
