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dc.contributor.authorNgetsa, Caroline J.
dc.contributor.authorHeymann, Marc W.
dc.contributor.authorThiong'o, Alex
dc.contributor.authorWahome, Elizabeth
dc.contributor.authorMwambi, John
dc.contributor.authorKarani, Clara
dc.contributor.authorMenza, Nelson C.
dc.contributor.authorMwashigadi, Grace
dc.contributor.authorMuturi, Margaret W.
dc.contributor.authorGraham, Susan M.
dc.contributor.authorMugo, Peter M.
dc.contributor.authorSanders, Eduard J.
dc.date.accessioned2021-04-16T06:38:20Z
dc.date.available2021-04-16T06:38:20Z
dc.date.issued2020
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/21996
dc.descriptionAn Article Published in Wellcome Open Researchen_US
dc.description.abstractBackground: Men who have sex with men (MSM) have a higher prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections compared to the rest of the population, often remaining undiagnosed. In Kenya, prevalence of rectal CT and NG infection and NG antimicrobial sensitivity are poorly described. Methods: MSM who reported receptive anal intercourse (RAI) were recruited from an ongoing human immunodeficiency virus acquisition and treatment study in coastal Kenya in 2016-2017. Rectal swabs were collected at two time points 6 months apart to estimate prevalence and incidence of CT/NG infection using a molecular point-of-care assay. Participants positive for CT or NG were treated according to national guidelines. NG culture and antimicrobial susceptibility testing was performed. Participant and risk behaviour characteristics were collected and association with baseline CT/NG prevalence assessed by multivariable regression analysis. Results: Prevalence of CT/NG in 104 MSM was 21.2% (CT 13.5%, NG 9.6%, dual infection 1.9%) at baseline and 25.9% in 81 MSM at follow-up (CT 14.8%, NG 14.8%, dual infection 3.7%). CT/NG incidence was estimated at 53.0 (95% CI, 34.5-81.3) per 100 person-years. Most CT/NG positive participants were asymptomatic: 95.5% at baseline and 100% at follow-up. CT/NG infection was associated with being paid for sex [adjusted odds ratio (aOR)=6.2, 95% CI (1.7-22.9)] and being in formal employment [aOR=7.5, 95% CI (1.1-49.2)]. Six NG isolates were obtained at follow-up; all were susceptible to ceftriaxone and cefixime and all were resistant to penicillin, tetracycline and ciprofloxacin. Conclusions: There is a high prevalence and incidence of asymptomatic rectal CT and NG in MSM reporting RAI in coastal Kenya. MSM who were paid for sex or had formal employment were more likely to be infected with CT/NG suggesting increased risk behaviour during transactional sex. Antimicrobial susceptibility results suggest that current antibiotic choices in Kenya are appropriate for NG treatment.en_US
dc.language.isoenen_US
dc.publisherWellcome Open Researchen_US
dc.subjectChlamydiaen_US
dc.subjectGonorrhoeaen_US
dc.subjectMen Who Have Sex With Menen_US
dc.subjectKenyaen_US
dc.subjectCefiximeen_US
dc.subjectAzithromycinen_US
dc.subjectAntimicrobial Susceptibilityen_US
dc.titleRectal Gonorrhoea and Chlamydia among Men Who Have Sex with Men in Coastal Kenyaen_US
dc.typeArticleen_US


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