Prevalence of sexually transmissible infections (STI) among male patients with STI in Denpasar and Makassar, Indonesia: are symptoms of urethritis sufficient to guide syndromic treatment?

BACKGROUND

There are few data on sexually transmissible infections in men in Indonesia. We conducted a prevalence study and compared symptoms alone with clinical signs to manage urethritis.

METHODS

We recruited symptomatic male patients at public clinics, and used standardised questionnaires, examinations and laboratory tests.

RESULTS

We recruited 273 men and the prevalences were Neisseria gonorrhoeae 18.2%, Chlamydia trachomatis 10.1%, and positive syphilis serology 5.2%. Four cases of HIV were detected. Urethral symptoms detected 91.7% of N. gonorrhoeae and/or C. trachomatis, and positive predictive value (PPV) was 41.8%, compared with clinical confirmation (sensitivity 86.1%, PPV 37.6%).

CONCLUSIONS

Most cases of syphilis were asymptomatic, supporting routine screening for syphilis. Urethral symptoms predicted infection with N. gonorrhoeae/C. trachomatis better than clinical signs.