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Malanda Nsuami

Publications and source records attributed to Malanda Nsuami.

7 recordsLinked to original sources
PubMed2006

Missed opportunities for early detection of chlamydia and gonorrhea in school-based health centers.

OBJECTIVE: The purpose of the study was to assess the extent to which students are screened for sexually transmitted diseases (STDs) in their school-based health centers (SBHCs) in a Louisiana school district. GOAL: The goal of this study was to determine the proportion of students who reported having been tested or treated for STDs at their SBHCs in the past 3 months and the prevalence of chlamydia and gonorrhea among respondents. STUDY DESIGN: During the 2002-2003 and 2003-2004 school years, 487 students registered in their SBHCs, and who visited routinely their SBHC at least once in the past 3 months, participated in a chlamydia and gonorrhea screening independent of services their SBHCs provide. Participants were asked whether in the past 90 days they had been tested or treated for an STD at their SBHC. RESULTS: Among respondents, 47/482 (9.8%) reported having been tested or treated for an STD at the SBHC in the previous 3 months. Overall, 65/487 (13.3%) tested positive for chlamydia or gonorrhea. Of the 65 students who tested positive, 53 (81.5%) were not tested or treated for an STD at the SBHC. CONCLUSIONS: Many infections could have been detected by testing students during routine visits in SBHCs. Lack of routine screening in these SBHCs clearly represents missed opportunities for early detection of chlamydia and gonorrhea among local teens.

Adolescent↗
PubMed2005

Initial and repeat testing for chlamydia during pregnancy.

OBJECTIVE: This study was done to evaluate the prevalence of chlamydia in late pregnancy after an initial negative test. METHODS: This retrospective cohort study reports prenatal patients entering care between January 1998 and May 2000 at an inner city community based clinic (n = 752). Patients were evaluated if results of initial and late tests (34 weeks gestational age) for chlamydia were known. Charts were abstracted for demographic and pregnancy-related factors. Analysis for categorized data was by chi-squares and odds ratios. Continuous data were analyzed by t-test. Significance was accepted if p < 0.05. RESULTS: The prevalence of chlamydia was 17.8%, with 3.9% having only the second test positive. Treatment failure and/or reinfection were found in 13.3%. Factors correlated with chlamydial carriage include: age 19 years (p < 0.001), gonorrheal carriage (p < 0.001), lower gravidity (p < 0.01), lower parity (p < 0.05), and never having married (p < 0.001). Logistic regression identified gonorrheal carriage and age 19 years as important for both initial and late chlamydial cervicitis. Marital status was important for initial tests only. CONCLUSIONS: In our high-risk population, repeat testing for chlamydia in late pregnancy was found appropriate.

Adolescent↗
PubMed2004

Chlamydia and gonorrhea co-occurrence in a high school population.

BACKGROUND: Chlamydia and gonorrhea coinfection outside of healthcare facilities is less well known. GOAL: To determine the co-occurrence of both sexually transmitted diseases (STDs) among high school students participating in a school-based screening and to assess the relevance of dual treatment recommendations in this population. STUDY DESIGN: During the 1998 to 1999 school year, 5,877 students attending an urban U.S. school district were screened for chlamydia and gonorrhea using urine ligase chain reaction assays. RESULTS: Overall, 451 students had chlamydia, 117 had gonorrhea, including 50 who had both STDs. The gonorrhea and chlamydia co-infections were 50/451 (11.1%) and 50/117 (42.7%), respectively. STD symptoms were reported by 16.0% of students having both infections, 7.7% of those having gonorrhea only, and 5.0% of students having chlamydia only (P = 0.01). CONCLUSIONS: The rates of coinfection in this population exceeded those that justify dual treatment in patient-care settings. Chlamydia and gonorrhea co-occurrence may be highly prevalent among certain populations not attending patient-care settings.

Adolescent↗
PubMed2004

Use of multiple nucleic acid amplification tests to define the infected-patient "gold standard" in clinical trials of new diagnostic tests for Chlamydia trachomatis infections.

Nucleic acid amplification tests (NAATs) can be used to define the infected-patient "gold standard" for the purpose of designing studies of the performance of Chlamydia trachomatis diagnostic tests. It is unclear how many test results run by different NAATs and what combinations of specimens comprise the best infected-patient gold standard. We approached this question with data from a large study of the performance of a new NAAT. Data were available from three endocervical swabs and a urine specimen collected from each of 1,412 women and tested by three different NAATs. Results from all three assays were used equally in a rotating fashion to define the infected-patient gold standard. Multiple different infected-patient gold standards for estimating swab and urine specimen sensitivity and specificity for one NAAT method were created by varying the number and combinations of swab and urine comparator results with two different NAATs, The effect of changing the infected-patient gold standard definition was determined by constructing receiver-operator-like curves with calculated sensitivities and specificities for each test. The one-positive-of-two-results or two-positive-of-two-results (same or two different assays) infected-patient gold standard definitions produced low sensitivity and low specificity estimates, respectively. If four comparator NAAT results were used, the any-three-positive-of-four-results definition or the at-least-one-specimen-positive-by-each-of-two-comparator-assays definition appeared to provide better combinations of sensitivity and specificity estimates. The any-two-positive-out-of-three-results definition resulted in estimates that were as good as produced with the former two definitions. This analytic approach provides a means of clearly visualizing the effects of changing NAAT-based infected-patient gold standards and should be helpful in designing future studies of new C. trachomatis diagnostic tests.

Cervix Uteri↗
PubMed2003

Screening for sexually transmitted diseases during preparticipation sports examination of high school adolescents.

In an urban school district, 636 students in grades 9-12 were tested for Chlamydia trachomatis and Neisseria gonorrhoeae by ligase chain reaction assays using specimens collected for routine urinalyses during sports physical examinations. Chlamydia and gonorrhea prevalences were 2.8% and 0.7% among males, and 6.5% and 2.0% among females, respectively. Among athletes infected with either sexually transmitted disease (STD), 93.1% reported no symptoms, and treatment was documented for 75.9%. Sports physicals offered a unique opportunity to screen and treat adolescents for STDs and to provide STD-prevention counseling.

Adolescent↗
PubMed2003

Initial and repeated screening for gonorrhea during pregnancy.

BACKGROUND AND GOAL: Late pregnancy rescreening is advised for at-risk patients, but data supporting this recommendation are lacking. The intent of this study was to determine the value of a late-pregnancy test for gonorrhea after a negative initial test at the beginning of prenatal care. STUDY DESIGN: A retrospective chart review of clinic records over a 29-month period identified patients with a positive DNA direct assay for gonorrhea either initially or at 34 weeks. RESULTS: Of 751 women, 38 (5.1%) had gonorrhea diagnosed at their first testing; 19 women (2.5%) were positive only at their second screening. For one patient, both tests were positive. CONCLUSION: Repeating screening for gonorrhea at 34 weeks in a high-prevalence population is warranted.

Adult↗