van Duynhoven Y T, Schop W A, van der Meijden W I, van de Laar M J
Department for Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, Bilthoven, Netherlands.
Sex Transm Infect. 1998 Oct;74(5):323-30. doi: 10.1136/sti.74.5.323.
To describe the outcome of patient referral at the STD clinic of the University Hospital Rotterdam. To study characteristics of heterosexual index patients and partnerships related to referral outcome.
In 1994, patients with gonorrhoea and chlamydia were referred to public health nurses for interview and patient referral. Referral outcome was classified as "verified" if partners attended the STD clinic and as "believed" if partners were said to have attended elsewhere.
Of 454 patients, 250 (55%) participated in the study. The outcome of patient referral for the 502 eligible partners was 103 (20.5%) verified referrals, 102 (20%) believed referrals, and 297 (59%) with unknown follow up. Of the 103 partners examined, 43 had an STD of which 63% reported no symptoms. The contact finding ratio was higher for chlamydia patients and heterosexual men. Also, referral was more effective for index patients with recent sexual contact, with follow up visits to the public health nurse, for men who were not commercial sex worker (CSW) clients, and, to a lesser degree, for Dutch patients and patients who sometimes used condoms. For steady partners, referral was improved if the last sexual contact was more recent. Casual partners visited the clinic more often if sexual contact occurred more than once, if the last contact was more recent, if they were older, and if they were Dutch.
Patient referral was more effective for certain groups, such as chlamydia patients and steady partners, but was inadequate for others, including CSW and their clients, other "one night stands", young partners, and ethnic minorities.
描述鹿特丹大学医院性传播疾病诊所患者转诊的结果。研究异性传播疾病索引患者的特征以及与转诊结果相关的性伴侣情况。
1994年,淋病和衣原体感染患者被转介给公共卫生护士进行访谈和患者转诊。如果性伴侣到性传播疾病诊所就诊,则转诊结果分类为“已核实”;如果性伴侣据称在其他地方就诊,则分类为“可信”。
454名患者中,250名(55%)参与了研究。502名符合条件的性伴侣的转诊结果为:103名(20.5%)已核实转诊,102名(20%)可信转诊,297名(59%)随访情况不明。在接受检查的103名性伴侣中,43名患有性传播疾病,其中63%报告无症状。衣原体感染患者和异性恋男性的接触者发现率更高。此外,对于近期有性接触、接受过公共卫生护士随访、非商业性性工作者(CSW)客户的索引患者,转诊更有效,在较小程度上,对于荷兰患者和有时使用避孕套的患者也更有效。对于固定性伴侣,如果最后一次性接触更近,则转诊效果更好。如果性接触不止一次、最后一次性接触更近、年龄较大且为荷兰人,临时性伴侣更常到诊所就诊。
患者转诊对某些群体更有效,如衣原体感染患者和固定性伴侣,但对其他群体则不足,包括性工作者及其客户、其他“一夜情”对象、年轻性伴侣和少数族裔。