• Edith Nakku-Joloba, Gerald Mboowa, Willy Ssengooba, Anthony Kiyimba, Edgar Kigozi, Hannington Baluku, Lucy Alinaitwe, Ronnie Nyote, Jupiter Marina Kabahita, Paul Mutumba, Fred A Katabazi, Noah Kiwanuka, Nelson Sewankambo, and David P Kateete.
• Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences. P.O. Box 7072, Kampala, Uganda.
• Afr Health Sci. 2022 Sep 1; 22 (3): 627162-71.

BackgroundSexually transmitted diseases (STDs) management in sub-Saharan Africa is syndromic but molecular diagnostics provide quicker, sensitive diagnosis and treatment. Effective STD control hinges on identification and treatment of infected persons and sexual partner contact tracing.ObjectivesThis study assessed feasibility of using the Xpert CT/NG test to identify prevalent Chlamydia trachomatis (CT) and Neisseria gonorrhea (NG) infections among STD clinic attendees and their sexual partners and tested for antimicrobial resistance for N. gonorrhea.MethodsA cross-sectional study was conducted at 4 outpatient STD clinics in Kampala, Uganda from February 2019 to October 2019. Participants received a syndromic diagnosis, were tested for NG and CT, as well as their sexual partners. Urine (men) and high vaginal swabs (women) were collected, examined using Xpert CT/NG assay. A total of 79 participants were enrolled at baseline of whom 25 had CT/NG. 21 partners of infected baseline participants and 7 partners of the 21 primary partners were enrolled.ResultsThe mean age of the reported sexual partners was 26 (18-43) years. The prevalence of NG was 25% at baseline and 18 % for CT. Nine (11.4%) people were dually infected. Men were more likely to have NG (p<0.001) at multivariable level. Two participants tested HIV-1 positive. On microbiological culture, 8 samples (2.5%) grew NG and all were resistant to penicillin, ciprofloxacin. For CT, we found a preponderance of the F-serovar in this population.ConclusionThe most prevalent organism was Neisseria gonorrhea. Generally, the prevalence of CT and NG was high. Infection proportions increased among primary partners, particularly women. Etiologic testing without partner tracing and treatment may underestimate burden of CT/NG in this population and contribute to re-infection.© 2022 Nakku-Joloba E et al.

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