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Cited by 34Reproductive tract infections researchAdolescent Sexual and Reproductive HealthSexual Assault and Victimization Studies

Genital and extragenital gonorrhea and chlamydia in children and adolescents evaluated for sexual abuse.

Kellogg, Nancy D., Melville, John D., Lukefahr, James L., Nienow, Shalon M., Russell, Edward L.·2018·Pediatric Emergency Care
DOI 10.1097/pec.0000000000001014
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Abstract

OBJECTIVE: The aim of this study was to describe the use of a nucleic acid amplification test in detecting genital and extragenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in children and adolescents assessed for sexual abuse/assault. METHODS: The charts of children aged 0 to 17 years, consecutively evaluated for sexual victimization, in emergency department and outpatient settings were reviewed. Data extracted included age, sex, type of sexual contact, anogenital findings, previous sexual contact, toxicology results, and sites tested for NG and CT. RESULTS: Of the 1319 patients who were tested, 579 were tested at more than 1 site, and 120 had at least 1 infected site. Chlamydia trachomatis was identified in 104 patients, and NG was found in 33. In bivariate analysis, a positive test was associated with female sex, age older than 11 years, previous sexual contact, acute or healed genital injury, drug/alcohol intoxication, and examination within 72 hours of sexual contact. Fifty-one patients had positive anal tests, and 24 had positive oral tests. More than 75% of patients with positive extragenital tests had additional positive tests or anogenital injury. Most with a positive anal (59%) or oral (77%) test did not report that the assailant's genitals came into contact with that site. CONCLUSIONS: Positive tests for NG and CT in patients evaluated for sexual victimization may represent infection from sexual contact, contiguous spread of infection, or the presence of infected assailant secretions. Relying on patient reports of symptoms, or types of sexual contact, to determine need for testing may miss NG and CT infections in patients evaluated for sexual victimization.

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  • History and reported type of sexual contact might not be a reliable indicator.

    “History and reported type of sexual contact might not be a reliable indicator, and urogenital, pharyngeal, and rectal testing should be considered for preverbal children and children who cannot verbalize details of the assault (1438,1449).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1449]

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Authors
Kellogg, N. D., Melville, J. D., Lukefahr, J. L., Nienow, S. M., & Russell, E. L.
Affiliations
  • The University of Texas at San Antonio Health Science Center (US)
  • Medical University of South Carolina (US)
  • University of New Mexico (US)
  • Children's Hospital of San Antonio (US)
Corresponding author
  • Kellogg, Nancy D.
  • Lukefahr, James L.
ORCID
Venue
Pediatric Emergency Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2018-11
Volume
34
Issue
11
Pages
761-766
ISSN
  • 0749-5161 (ISSN-L)
  • 1535-1815
DOI
10.1097/pec.0000000000001014
OpenAlex
W2567722763
Cited by
34
References
25
Citations by year
2026: 2 · 2025: 5 · 2024: 3 · 2023: 5 · 2022: 1 · 2021: 6 · 2020: 4 · 2019: 4 · 2018: 1 · 2017: 2
FWCI
2.44
Type
journal article
Language
en
Open access
closed
Locations
  • Pediatric Emergency Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
  • Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
Keywords
gonorrhea, chlamydia, Neisseria gonorrhoeae, Chlamydia trachomatis, sexual abuse, child sexual assault, children and adolescents, extragenital infection, anal infection, oral infection, nucleic acid amplification tests, anogenital injuries
MeSH terms
Adolescent, Child, Child, Preschool, Chlamydia Infections, Chlamydia trachomatis, Female, Gonorrhea, Humans, Infant, Male, Neisseria gonorrhoeae, Retrospective Studies, Risk Factors, Sexual Behavior, Sex Offenses, Crime Victims, Nucleic Acid Amplification Techniques

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