Taylor M M, Reilley B, Yellowman M, Anderson L, de Ravello L, Tulloch S
Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, GA, USA.
Int J STD AIDS. 2013 May;24(5):371-4. doi: 10.1177/0956462412472825. Epub 2013 Jun 18.
Chlamydia cases diagnosed in the women's clinic were more likely to receive expedited partner therapy (EPT) and to be re-tested as compared with urgent and emergent care settings. Fewer re-infections occurred among patients who received EPT. Disproportionate rates of chlamydia occur among American Indian (AI) populations. To describe use of EPT among chlamydia cases diagnosed at an urban Indian Health Service (IHS) facility in Arizona, health records were used to extract confirmed cases of chlamydia diagnosed between January 2009 and August 2011. Medical records of 492 patients diagnosed with chlamydia were reviewed. Among the 472 cases who received treatment, 246 (52%) received EPT. Receipt of EPT was significantly associated with being female (odds ratio (OR) 2.1, 1.03-4.4, P < 0.001) and receipt of care in the women's clinic (OR 9.9, 95% CI 6.0-16.2) or in a primary care clinic (OR 2.4, 95% CI 1.1-5.1). Compared with those receiving care in the women's clinic, the odds of receipt of EPT were significantly less in those attending the urgent/express care clinic (OR 0.1, 95% CI 0.06-0.2), and the emergency department (OR 0.1, 95% CI 0.05-0.2). Among treated patients who underwent re-testing (N = 323, 68% total treated) re-infection was less common among those that received EPT (13% versus 27%; OR 0.5, 95% CI 0.3-0.9). In this IHS facility, EPT was protective in preventing chlamydia re-infection. Opportunities to expand the use of EPT were identified in urgent and emergent care settings.
与急诊和紧急护理机构相比，在妇女诊所诊断出的衣原体病例更有可能接受加速性伴侣治疗（EPT）并接受重新检测。接受EPT的患者再次感染的情况较少。美国印第安人（AI）人群中衣原体感染率不成比例。为了描述在亚利桑那州一家城市印第安卫生服务（IHS）机构诊断出的衣原体病例中EPT的使用情况，利用健康记录提取了2009年1月至2011年8月期间确诊的衣原体病例。对492例被诊断为衣原体感染的患者的病历进行了审查。在接受治疗的472例病例中，246例（52%）接受了EPT。接受EPT与女性（优势比（OR）2.1，1.03 - 4.4，P < 0.001）以及在妇女诊所（OR 9.9，95%置信区间6.0 - 16.2）或初级保健诊所接受护理（OR 2.4，95%置信区间1.1 - 5.1）显著相关。与在妇女诊所接受护理的患者相比，在急诊/快速护理诊所就诊的患者接受EPT的几率显著较低（OR 0.1，95%置信区间0.06 - 0.2），在急诊科就诊的患者也是如此（OR 0.1，95%置信区间0.05 - 0.2）。在接受重新检测的治疗患者中（N = 323，占总治疗人数的68%），接受EPT的患者再次感染的情况较少（13%对27%；OR 0.5，95%置信区间0.3 - 0.9）。在这家IHS机构中，EPT对预防衣原体再次感染具有保护作用。在急诊和紧急护理机构中发现了扩大EPT使用的机会。
