Prevalence, Treatment, and Follow-Up for Lymphogranuloma Venereum Serovars of Chlamydia trachomatis Among Gay, Bisexual, and Other Men Who Have Sex With Men Attending Sexually Transmitted Infection Clinics in Alberta, Canada, 2018 to 2022
Bibliographic record
Abstract
BACKGROUND: Outbreaks of lymphogranuloma venereum (LGV) have been reported among gay, bisexual, and men who have sex with other men (gbMSM) in Europe and North America. In Alberta, Canada, a universal surveillance program was initiated to assess LGV rates among gbMSM seen at provincial sexually transmitted infection clinics. Our study examines the epidemiological characteristics and treatment of cases. METHODS: We describe a prospective, multicenter LGV surveillance program using chlamydia-positive nucleic acid amplification test specimens from gbMSM collected at 3 sexually transmitted infection clinics between April 2018 and July 2022. Chlamydia-positive specimens from rectal, pharyngeal, and urine specimens were sent for LGV typing. Treatment and test of cure for LGV-confirmed cases were followed. Demographic variables were compared between LGV-positive and LGV-negative specimens using χ2 tests for categorical variables and Mann-Whitney U tests for continuous variables. RESULTS: Eighty-five percent (n = 2333) of all chlamydia-positive specimens were tested for LGV, and 45 (1.9%; 95% confidence interval, 1.4%-2.5%) specimens were confirmed to be LGV. A majority (n = 1374) of specimens submitted for LGV testing were rectal swabs, of which 37 (2.7%) were positive. One-half (51.2% [22 of 43]) of cases were asymptomatic. Of the 22 cases with a negative test-of-cure result, 9 (40.9%) patients received doxycycline 100 mg twice a day for 21 days, 7 (31.8%) patients received azithromycin 1 g as a single dose, 5 (22.7%) patients received doxycycline 100 mg twice a day for 7 days, and 1 patient (4.6%) was treated with doxycycline 100 mg twice a day for 14 days. CONCLUSIONS: Universal testing increased the detection of LGV among asymptomatic patients. Future research should consider the impact of asymptomatic LGV in transmission networks and the role of alternate, shorter treatment regimens than the recommended 21 days of doxycycline.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".