Opportunistic chlamydia screening; should positive patients be screened for co-infections?

2002 ◽  
Vol 13 (12) ◽  
pp. 821-825 ◽  
Author(s):  
V Harindra ◽  
J M Tobin ◽  
G Underhill
Keyword(s):  
Pilot Study ◽  
Sexual Partners ◽  
Chlamydia Screening ◽  
Opportunistic Screening ◽  
Male Partners ◽  
Community Group ◽  
Sexually Transmitted ◽  
Department Of Health ◽  
Male Patients ◽  
Genitourinary Medicine

This study examines the requirement for testing patients for other sexually transmitted infections (STIs) and bacterial vaginosis (BV) when diagnosed with genital chlamydia during opportunistic screening. Data were collected on all patients participating in the Department of Health chlamydia screening pilot study in Portsmouth. One thousand two hundred and forty-five women and 490 men with genital chlamydia were seen in Portsmouth genitourinary medicine (GUM) department. Of the women screened in GUM, 28% had coexisting STIs and 21% had BV. The corresponding figures for those initially screened in the community were 4% and 17%. An increased number of female sexual partners of male patients (76%) and male partners of female patients (55%) of the GUM group had co-infections; 58% of male partners from the community group had another STI. The increased morbidity associated with these infections warrants screening of all patients with chlamydia for other STIs and BV.

Acceptance of genitourinary medicine clinic appointments within 48 hours is influenced by patient perception of risk but not by symptoms

2009 ◽  
Vol 20 (9) ◽  
pp. 644-646 ◽  
Author(s):  
N M Steedman ◽  
V Worsnop ◽  
R Fernie
Keyword(s):  
Public Education ◽  
Health Risk ◽  
Sexually Transmitted Infection ◽  
Patient Perception ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Department Of Health ◽  
Genitourinary Medicine ◽  
Patient’S Perception ◽  
Perception Of Health

The Department of Health has addressed access to genitourinary medicine services by setting targets that 100% of patients should be offered an appointment within 48 hours of contact and 95% should be seen within 48 hours. Such rapid access appointments are often declined by patients. We wished to ascertain whether patient perception of health risk or the presence of symptoms suggestive of a sexually transmitted infection (STI) might influence how quickly patients accept an appointment. We designed a two-armed study which demonstrated that up to 37% of patients offered an appointment within 48 hours declined it, with work commitments offered by 84% of these patients as the reason for deferring attendance. The presence of symptoms did not influence whether patients accepted an early appointment, however the patient's perception of health risk associated with an untreated STI was statistically significantly associated with earlier attendance ( P < 0.0001). Increased public education regarding the consequences of untreated STI may therefore improve the acceptance by patients of appointments within 48 hours.

Chlamydia screening

2018 ◽  
Vol 11 (7) ◽  
pp. 366-370
Author(s):  
Rabia Aftab
Keyword(s):  
Public Health Problem ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Major Public Health Problem ◽  
Unborn Child ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Genitourinary Medicine ◽  
Sexual Health Clinics

Sexually transmitted infections (STIs) are a major public health problem worldwide, affecting quality of life, adding economic burden and causing serious morbidity. Chlamydia infection is the most common bacterial STI, making up a large proportion of the over 1 000 000 STIs acquired every day. Although easily cured with antibiotics, untreated chlamydial infection can have serious consequences affecting reproductive health and the unborn child. Since chlamydia infection is typically asymptomatic, screening provides an opportunity to prevent complications and reduce transmission. With long waits for genitourinary medicine appointments and busy sexual health clinics, screening in primary care can help to improve chlamydia detection and treatment rates.

scholarly journals Opportunistic screening for Chlamydia: a pilot study into male perspectives on provision of Chlamydia screening in a UK university

2008 ◽  
Vol 30 (4) ◽  
pp. 466-471 ◽  
Author(s):  
R. Chaudhary ◽  
C. M. Heffernan ◽  
A. L. Illsley ◽  
L. K. Jarvie ◽  
C. Lattimer ◽  
...  
Keyword(s):  
Pilot Study ◽  
Chlamydia Screening ◽  
Opportunistic Screening

Audit of official STD returns from genitourinary medicine

2002 ◽  
Vol 13 (10) ◽  
pp. 720-721
Author(s):  
A Tariq ◽  
M Huengsberg ◽  
A Cook ◽  
J D C Ross
Keyword(s):  
Sexually Transmitted Infections ◽  
Clinical Diagnosis ◽  
Anogenital Warts ◽  
Chi Square ◽  
Sexually Transmitted ◽  
Department Of Health ◽  
Audit Period ◽  
Genitourinary Medicine ◽  
Improving Accuracy

We audited the accuracy of KC60 coding in our department over a two-week period in 1999. Case notes of 400 consecutive new and rebook patients who attended during each of the audit periods were reviewed, and their clinical diagnosis was compared with KC60 returns entered into the computer and sent to the Department of Health. We concentrated on four KC60 diagnoses of positive sexually transmitted infections: uncomplicated gonorrhoea (B1) and chlamydia (c4a), first episodes of anogenital warts (C11a) and herpes (C10a). At the end of the audit, specific recommendations were introduced, aiming at improving accuracy of KC60 coding, and a re-audit was carried out in 2000, using identical methodology. In the first audit period there were 106 positive diagnoses, of which 41 (38.7%) were not recorded in the KC60 returns. In the second audit period there were 149 positive diagnoses, of which 20 (13%) were not recorded, showing a significant improvement (Chi square P = 0.0005).

The three-year positivity rate of sexually transmitted infections among a group of HIV-infected men attending the Department of Genitourinary Medicine, Edinburgh, UK

2005 ◽  
Vol 16 (11) ◽  
pp. 730-732 ◽  
Author(s):  
K Manavi ◽  
P L Luo ◽  
A McMillan
Keyword(s):  
T Cells ◽  
Observational Study ◽  
Sexually Transmitted Infections ◽  
Safe Sex ◽  
Study Cohort ◽  
Sexually Transmitted ◽  
Viral Loads ◽  
Highly Active ◽  
Male Patients ◽  
Genitourinary Medicine

The aim of this study was to investigate the prevalence of sexually transmitted infections (STI) among patients at the time of and subsequent to the diagnosis of HIV, and possible immunological or virological features of patients with STI. An observational study was carried out on the results of annual STI screenings conducted on consecutive HIV-infected men in the Department of Genitourinary Medicine, Edinburgh between 1 January 1999 and 1 January 2003. Patients were tested for syphilis, gonococcal, and chlamydial infections. Among the 79 male patients in the study cohort, the frequencies of all STI rose within the study period. The three-year positivity rates of episodes of gonorrhoea, chlamydia, and syphilis were (42/131) 32%, (21/127) 16%, and (13/150) 9%, respectively. Patients with STI had significantly higher median CD4+ T-cells ( P<0.02) and lower median viral loads ( P<0.0001), and a higher proportion of them were on highly active anti-retroviral therapy (HAART) ( P<0.0002) compared with those without an STI. Routine screening for STI and counselling for safe sex should be part of care for all HIV-infected patients.

scholarly journals MISSED OPPORTUNITIES OF CHLAMYDIA AND GONORRHEA DETECTION WHEN NOT USING EXTRA GENITAL SCREENING AMONG MALES

2018 ◽  
Author(s):  
Chelsea Schafer ◽  
Belinda Prado ◽  
Nora Barin ◽  
Leslie Gama
Keyword(s):  
Sexual Behaviors ◽  
Human Services ◽  
Screening Methods ◽  
Long Beach ◽  
Missed Opportunities ◽  
Patients Âgés ◽  
Sexually Transmitted ◽  
Health And Human Services ◽  
Department Of Health ◽  
Male Patients

AbstractBackgroundThrough extra genital screening methods, Health Departments and community clinics can increase detection of sexually transmitted diseases (STDs) through the application of urethral testing. The Long Beach Department of Health and Human Services (LBDHHS) works on preventing cases of chlamydia (CT) and gonorrhea (GC) from being undiagnosed, by providing extra genital screening.MethodsRetrospective medical review of 1,571 patient health records, who received CT/GC testing, based on at least 1-visit to the Long Beach Department of Health & Human Services, STD Clinic, between 2012 to 2015. All male patients ages 18 years or older with positive CT/GC results (242 cases) for any of the three sites (e.g. urethral, rectal, and pharyngeal); regardless of their sexual behaviors, were included in the study. Females, those under the age of 18, and patients who tested negative for all three anatomical sites were excluded (1,412 controls).ResultsAt time of collection, study participants had a mean age of 37 years. Reported ethnicity indicated 56% Caucasian, 21% Hispanic or Latino, 9% Asian or Pacific Islander, 7% Other, 5% Black, and 2% More than one race. The use of extra genital screening detected 15% (242) of the 1,571 patients tested positive for at least 1-type of CT/GC infection. Our findings demonstrated that if urine was the only specimen collected, then over 29.7% of CT and 46.8% of GC cases would have been missed.ConclusionsTesting of all three anatomical sites should continue to be performed for CT/GC detection. Cases of CT/GC are underreported if performing urethral screening alone. These results highlight the need for clinicians to perform extra genital screening among male patients for prevention and control. These testing measures may reduce the potential for missing a diagnosis and mitigating transmission.Short SummaryThe number of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infections missed were determined using extra genital screening procedures among male patients from the Long Beach Department of Health and Human Services (LBDHHS), STD/Family Planning Clinic. This method tests urethral, pharyngeal, and rectal sites for CT and GC infection. In this retrospective review of 1,571 patient files, of which 242 tested positive, we determined the proportion of cases that would have remained undetected if only using urethral screening.

Modernization in GUM/HIV services: what does it mean?

2003 ◽  
Vol 14 (2) ◽  
pp. 89-98 ◽  
Author(s):  
Angela J Robinson ◽  
Karen Rogstad
Keyword(s):  
Quality Of Service ◽  
Sexually Transmitted Infections ◽  
21St Century ◽  
Working Group ◽  
Local Population ◽  
Hiv Services ◽  
Sexually Transmitted ◽  
Measuring Outcomes ◽  
Genitourinary Medicine

Genitourinary medicine services are expected to modernize in order to meet the needs of the NHS in the 21st century. Although increased funding is essential, there is a need for services to look at new ways of delivering care in order to deal with the increasing rate of sexually transmitted infections (STIs) including HIV in the community. This must include a review of skill-mix and roles. Some changes may appear to lower the quality of service. There must be auditing of changes to ensure that standards are not lowered. A short-lived working group was put together at the request of the RCP joint speciality committee for GUM consisting of representatives from diverse GUM clinics which have all been involved in extensive modernization of their service in order to meet demand. This report does not hold all the answers but provides suggestions for clinics wishing to initiate change. Changes must be appropriate to the local population and access pressures. More extreme measures may only be appropriate in the most severely stretched clinics and with consideration of measuring outcomes.

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