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淋病的性伴通知:与英国一个省级诊所和一个大都市诊所的比较研究。

Partner notification for gonorrhoea: a comparative study with a provincial and a metropolitan UK clinic.

作者信息

Bell G, Ward H, Day S, Ghani A C, Goan U, Claydon E, Kinghorn G R

机构信息

Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield.

出版信息

Sex Transm Infect. 1998 Dec;74(6):409-14. doi: 10.1136/sti.74.6.409.

Abstract

OBJECTIVE

To compare partner notification practice and outcomes at a provincial and a metropolitan clinic.

DESIGN

Prospective study, following standardisation of partner notification policy.

SETTINGS

Sheffield Department of Genitourinary Medicine, Royal Hallamshire Hospital and Jefferiss Wing Centre for Sexual Health, St Mary's Hospital, London.

SUBJECTS

Consecutive patients with culture positive gonorrhoea between October 1994 and March 1996 who were interviewed by a health adviser.

RESULTS

In Sheffield, 235 cases reported 659 outstanding contacts, of whom 129 (20%) were subsequently screened, and 65 (50%) had gonorrhoea. At St Mary's 510 cases reported 2176 outstanding contacts, of whom 98 (5%) were known to have been screened, and 53 (54%) had gonorrhoea. Patient or provider referral agreements appeared more productive in Sheffield, where 60% resulted in contact attendance, compared with 13% at St Mary's. Provider referral was used more frequently in Sheffield, for 44% of referrals, compared with 1% at St Mary's. Multivariate analysis showed that partner notification was less effective for casual and short term (< 7 days) partnerships in both centres, and for homosexual men at St Mary's.

CONCLUSION

Partner notification outcomes were better in the provincial setting where contact attendance could be recorded more reliably and provider referral was used more extensively. The high proportion of contacts who remained untraced in both settings indicates the need for complementary screening and prevention initiatives.

摘要

目的

比较省级诊所和大都市诊所的性伴通知实践及结果。

设计

在性伴通知政策标准化后进行的前瞻性研究。

地点

谢菲尔德皇家哈勒姆郡医院泌尿生殖医学部以及伦敦圣玛丽医院杰弗里斯翼性健康中心。

研究对象

1994年10月至1996年3月期间连续的淋病培养阳性患者,由健康顾问进行访谈。

结果

在谢菲尔德,235例患者报告了659名未通知的性伴,其中129名(20%)随后接受了筛查,65名(50%)患有淋病。在圣玛丽医院,510例患者报告了2176名未通知的性伴,其中已知98名(5%)接受了筛查,53名(54%)患有淋病。患者或医疗机构转诊协议在谢菲尔德似乎更有效,60%的转诊导致性伴前来就诊,而在圣玛丽医院这一比例为13%。在谢菲尔德,医疗机构转诊的使用频率更高,占转诊的44%,而在圣玛丽医院仅为1%。多变量分析显示,在两个中心,性伴通知对随意和短期(<7天)性伴关系效果较差,在圣玛丽医院对男同性恋者效果也较差。

结论

在省级诊所,性伴通知结果更好,在那里可以更可靠地记录性伴就诊情况,且医疗机构转诊的使用更为广泛。在两个诊所中,仍有很大比例的性伴未被追踪到,这表明需要采取补充筛查和预防措施。

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