scholarly journals Improving surveillance of sexually transmitted infections using mandatory electronic clinical reporting: the genitourinary medicine clinic activity dataset, England, 2009 to 2013

2014 ◽  
Vol 19 (48) ◽  
Author(s):  
E J Savage ◽  
H Mohammed ◽  
G Leong ◽  
S Duffell ◽  
G Hughes

A new electronic surveillance system for sexually transmitted infections (STIs) was introduced in England in 2009. The genitourinary medicine clinic activity dataset (GUMCAD) is a mandatory, disaggregated, pseudo-anonymised data return submitted by all STI clinics across England. The dataset includes information on all STI diagnoses made and services provided alongside demographic characteristics for every patient attendance at a clinic. The new system enables the timely analysis and publication of routine STI data, detailed analyses of risk groups and longitudinal analyses of clinic attendees. The system offers flexibility so new codes can be introduced to help monitor outbreaks or unusual STI activity. From January 2009 to December 2013 inclusive, over twenty-five million records from a total of 6,668,648 patients of STI clinics have been submitted. This article describes the successful implementation of this new surveillance system and the types of epidemiological outputs and analyses that GUMCAD enables. The challenges faced are discussed and forthcoming developments in STI surveillance in England are described.

2006 ◽  
Vol 17 (3) ◽  
pp. 193-195 ◽  
Author(s):  
K Manavi ◽  
A McMillan

Bacterial sexually transmitted infections (STIs) may be markers of high-risk sexual activity. Counselling for these infections provides an opportunity for promoting HIV testing. The aim of the present study was to compare the uptake of HIV testing between patients with gonorrhoea or chlamydial infections and those without a bacterial STI. A study on patients screened for chlamydial or gonococcal infections in the Department of Genitourinary (GU) Medicine, Edinburgh between 1 July 2002 and 30 June 2003. The overall uptake of HIV testing among patients screened for chlamydial and gonococcal infections was 2263 (37%) of 6184 and 2012 (44%) of 4583, respectively ( P < 0.0002). Uptake of HIV testing was significantly higher among uninfected patients: for chlamydial infection, 17% of 1857 infected patients versus 45% of 4327 uninfected patients ( P < 0.0002); and for gonococcal infection, 24% of 256 infected patients versus 45% of 4327 uninfected patients ( P < 0.0002). The policy of pre-test counselling needs to be redesigned in order to improve the uptake of HIV testing among patients with high-risk sexual activity.


2003 ◽  
Vol 14 (2) ◽  
pp. 89-98 ◽  
Author(s):  
Angela J Robinson ◽  
Karen Rogstad

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.


2020 ◽  
Vol 31 (11) ◽  
pp. 1073-1081
Author(s):  
Liuyuan Wang ◽  
Bin Yang ◽  
Lai S Tso ◽  
Peizhen Zhao ◽  
Wujian Ke ◽  
...  

Prevalence of co-infecting sexually transmitted infections (STIs) among patients newly diagnosed with anogenital warts is under-reported. Our objective is to determine the prevalence of six common STIs, Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), genital herpes (herpes simplex virus type 2 [HSV-2]), HIV, and syphilis for patients visiting a sexual health clinic in Guangzhou, China. Demographics, sexual health, and medical histories were collected at patient intake. Patients diagnosed with anogenital warts (N = 200) were invited to participate. We collected urine samples, and urethral, cervical, and rectal swabs to test for CT, NG, and MG, and blood samples for serological detection of HSV-2, syphilis, and HIV. Overall 49 (24.5%) had a co-infection (22.2% of men and 27.7% of women). All six STIs were observed among men: CT (6.8%), NG (3.4%), MG (5.1%), HIV (4.3%), HSV-2 (4.3%), and syphilis (1.7%). Women had fewer STIs, but at higher rates: CT (13.3%), MG (6.0%), and HSV-2 (8.4%). Individual men had up to two co-infections, while women had no more than one co-infection. Chlamydia was the most common STI. Patients aged 18–25 years (35.4%) had the highest prevalence. Although opportunistic screening is often applied for high-risk groups, expansion to patients with anogenital warts in all health-care settings would improve detection of problematic asymptomatic co-infections, thereby increasing China’s capacity to contribute toward global surveillance systems.


2019 ◽  
Vol 30 (5) ◽  
pp. 486-495
Author(s):  
Kara K Osbak ◽  
Conor J Meehan ◽  
Sergio G Ribas ◽  
Leo Heyndrickx ◽  
Kevin K Ariën ◽  
...  

In this study, we assessed if the superimposition of incident sexually transmitted infections (STIs) on HIV phylogenetic analyses could reveal possible sexual behaviour misclassifications in our HIV-infected population. HIV-1 sequences collected between 1997 and 2014 from 1169 individuals attending a HIV clinic in Antwerp, Belgium were analysed to infer a partial HIV transmission network. Individual demographic, clinical and laboratory data collected during routine HIV follow-up were used to compare clustered and non-clustered individuals using logistic regression analyses. In total, 438 (37.5%) individuals were identified in 136 clusters, including 76 transmission pairs and 60 clusters consisting of three or more individuals. Individuals in a cluster were more likely to have a history of syphilis, Chlamydia and/or gonorrhoea (P < 0.05); however, when analyses were stratified by HIV transmission risk groups (heterosexual and men who have sex with men [MSM]), this association only remained significant for heterosexuals with syphilis (P = 0.001). Under closer scrutiny, this association was driven by six heterosexual men who were located in six almost exclusively MSM clusters. A parsimonious conclusion is that these six individuals were potentially misclassified as heterosexual. Improving the accuracy of sexual behaviour reporting could improve care.


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