5 SCREENING FOR PHAPYNCEAL CONDRLEA IN IRAN TENNAGERS

Abstract

Studies of adult VD clinics, world-wide, report that the prevalence of pharyngeal gonorrhea (GC) varies from 1.3% to 5.7%, but the incidence among adolescents has not been delineated. A retrospective chart review was conducted to assess the usefulness of pharyngeal cultures in GC screening with urban adolescents. The study population was teenagers who visited the Adolescent Clinic and were cultured for GC; they were routinely cultured at all 3 sites (cervix or urethra, rectum and pharynx) regardless of their history of sexual practice. From Dec. 1979 to Oct. 1930, documented cultures at 3 sites were recorded for 546 patients (no record of sexual practice was available). This population was predominantly urban, black (95%) and female (90%); the age range was 11 to 22 years. Positive cultures were confirmed by fluorescent antibody reaction followed by sugar fermentation (for doubtful reactions).

The overall occurrence of GC was 14.7%. Pharyngeal GC was detected in 2.7% of the study population, representing 12 females and 3 males (mean age 15.1, range 12-19). Of the 80/546 patients with GC, 15% had only pharyngeal GC. History was available for 11 of these 12 patients: none had pharyngeal symptoms. Five were detected at a routine family-planning visit and six had genital-tract symptoms.Particularly in the context of routine screening in a general adolescent clinic, the occurrence of pharyngeal GC is sufficiently high to merit study of indications for pharyngeal culture of teenage patients. A positive history of fellatio/cunnilingus may be an adequate indicator, as reported for adults. Alternatively, it may prove appropriate to culture adolescents routinely for pharyngeal GC, regardless of stated sexual practice.

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