{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T01:35:58Z","timestamp":1768613758962,"version":"3.49.0"},"reference-count":28,"publisher":"BMJ","issue":"6","funder":[{"name":"LINKAGES"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,6,10]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Routine screening for <jats:italic>Chlamydia trachomatis<\/jats:italic> (CT) and <jats:italic>Neisseria gonorrhoeae<\/jats:italic> (NG) infections in sexually exposed anatomical sites may be challenging in resource-limited settings. The objective of this study was to determine the proportion of missed CT\/NG diagnoses if a single anatomical site screening was performed among men who have sex with men (MSM) by examining the pattern of anatomical sites of CT\/NG infections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Thai MSM were enrolled to the community-led test and treat cohort. Screening for CT\/NG infections was performed from pharyngeal swab, rectal swab and urine using nucleic acid amplification testing. The correlations of CT\/NG among the three anatomical sites were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1610 MSM included in the analysis, 21.7% had CT and 15.5% had NG infection at any anatomical site. Among those tested negative for CT or NG infection at either pharyngeal, rectal or urethral site, 8%\u201319% had CT infection and 7%\u201312% had NG infection at the remaining two sites. Of the total 349 CT infections, 85.9%, 30.6% and 67.8% would have been missed if only pharyngeal, rectal or urethral screening was performed, respectively. Of the total 249\u2009NG infection, 55.7%, 39.6% and 77.4% would have been missed if only pharyngeal, rectal or urethral screening was performed, respectively. The majority of each anatomical site of CT\/NG infection was isolated to their respective site, with rectal site having the highest proportion of isolation: 78.9% of rectal CT and 62.7% of rectal NG infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A high proportion of CT\/NG infections would be missed if single anatomical site screening was performed among MSM. All-site screening is highly recommended, but if not feasible, rectal screening provides the highest yield of CT\/NG diagnoses. Effort in lowering the cost of the CT\/NG screening test or developing affordable molecular technologies for CT\/NG detection is needed for MSM in resource-limited settings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial Registration Number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT03580512\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial results\">NCT03580512<\/jats:ext-link>; Results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-028162","type":"journal-article","created":{"date-parts":[[2019,6,28]],"date-time":"2019-06-28T05:45:20Z","timestamp":1561700720000},"page":"e028162","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Correlations of chlamydia and gonorrhoea among pharyngeal, rectal and urethral sites among Thai men who have sex with men: multicentre community-led test and treat cohort in Thailand"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct03580512","registry":"10.18810\/clinical-trials-gov","type":"results"},{"clinical-trial-number":"nct03580512","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1906-8171","authenticated-orcid":false,"given":"Akarin","family":"Hiransuthikul","sequence":"first","affiliation":[{"name":"PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanthip","family":"Sungsing","sequence":"additional","affiliation":[{"name":"PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jureeporn","family":"Jantarapakde","sequence":"additional","affiliation":[{"name":"PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deondara","family":"Trachunthong","sequence":"additional","affiliation":[{"name":"PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Mills","sequence":"additional","affiliation":[{"name":"LINKAGES Thailand FHI360, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravipa","family":"Vannakit","sequence":"additional","affiliation":[{"name":"Office of Public Health, United States Agency for International Development, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praphan","family":"Phanuphak","sequence":"additional","affiliation":[{"name":"PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nittaya","family":"Phanuphak","sequence":"additional","affiliation":[{"name":"PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,6,27]]},"reference":[{"key":"2025101814093231000_9.6.e028162.1","unstructured":"Centers for Disease Control and Prevention. 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