Correlates of time to clinical presentation for symptomatic individuals with gonorrhoea in South China: results from a cross-sectional study

OBJECTIVES: This study aimed to determine the variation in the interval between the onset of symptoms and clinical presentation, and its associated factors among symptomatic individuals with gonorrhoea. DESIGN: A cross-sectional study was conducted between 1 June and 30 July 2017. SETTING: 129 sexually transmitted disease clinics from 21 cities of Guangdong, China. PARTICIPANTS: Using convenience sampling method to recruit symptomatic individuals with gonorrhoea over 18 years old. OUTCOME MEASURE: Time to clinical presentation. RESULTS: Among 1664 participants, the median age was 29 (24–36) years old, and the majority were male (92.5%) and married (52.9%). The median time to clinical presentation was 3 (2–6) days. About 471 (28.3%) patients had sexual contact while symptomatic. After adjusting for covariates, participants who were female (aβ=0.44, 95% CI: 0.22 to 0.80), from east Guangdong region (aβ=0.44, 95% CI: 0.22 to 0.80) and had the absence of dysuria (aβ=0.26, 95% CI: 0.06 to 0.46) had increased time to clinical presentation. Participants who had commercial sex in the past 6 months (aβ=−0.11, 95% CI: −0.21 to –0.01) had decreased time to clinical presentation. Participants who were female (adjusted odds ratio (aOR)=1.66, 95% CI: 1.08 to 2.50) and delayed in seeking healthcare more than 7 days (aOR=46.71, 95% CI: 24.27 to 89.93) were more likely to have sexual contact while symptomatic. CONCLUSION: The time to clinical presentation for individuals with symptomatic gonorrhoea is variable and a high proportion of participants continued to have sexual behaviour while symptomatic. Strategies to increase health literacy may help to minimise the sequelae of gonorrhoea and reduce onward transmission.