Delair Shirley F, Lyden Elizabeth R, O'Keefe Anne L, Simonsen Kari A, Nared Sherri R, Berthold Elizabeth A, Watanabe-Galloway Shinobu
Division of Infectious Diseases, Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA.
Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
J Community Health. 2016 Apr;41(2):289-95. doi: 10.1007/s10900-015-0095-0.
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the two most commonly reported sexually transmitted infections (STIs) in the United States (U.S.) and Douglas County, Nebraska has STI rates consistently above the U.S. average. The Douglas County Health Department (DCHD) developed an outreach CT and NG screening program in public libraries to address the problem beyond the traditional STI clinic setting. This study evaluates the effectiveness of the program and identifies factors predictive of CT and NG infections. A retrospective review of surveys of library patrons and DCHD traditional STI clinic clients who submitted urine tests for CT and NG from June 2010 through April 2014 was done. Chi square, Fisher exact, Student's t tests, univariate and multivariate logistic regression were conducted. A total of 977 library records and 4871 DCHD clinic records were reviewed. The percent positive was lower in the library than in the traditional clinic for CT (9.9 vs. 11.2 %) and NG (2.74 vs. 5.3 %) (p = 0.039 and p < 0.001, respectively). Library clients were more likely to be 19 years and younger (OR 6.14, 95 % CI: 5.0, 7.5), Black (OR 3.4, 95 % CI: 2.8, 4.1), and asymptomatic (OR 12.4, 95 % CI: 9.9, 15.5) compared to traditional clinic clients. The library STI screening program effectively reaches a younger, asymptomatic, and predominantly Black population compared to a traditional health department clinic site.
沙眼衣原体(CT)和淋病奈瑟菌(NG)是美国报告最多的两种性传播感染(STI),内布拉斯加州道格拉斯县的性传播感染率一直高于美国平均水平。道格拉斯县卫生局(DCHD)在公共图书馆开展了一项衣原体和淋病筛查外展项目,以在传统性传播感染诊所环境之外解决这一问题。本研究评估了该项目的有效性,并确定了预测衣原体和淋病感染的因素。对2010年6月至2014年4月期间提交衣原体和淋病尿液检测的图书馆读者及DCHD传统性传播感染诊所患者的调查进行了回顾性分析。进行了卡方检验、费舍尔精确检验、学生t检验、单因素和多因素逻辑回归分析。共审查了977份图书馆记录和4871份DCHD诊所记录。衣原体检测中,图书馆的阳性率低于传统诊所(9.9%对11.2%),淋病检测中也是如此(2.74%对5.3%)(p值分别为0.039和p<0.001)。与传统诊所患者相比,图书馆读者更可能为19岁及以下(比值比6.14,95%置信区间:5.0,7.5)、黑人(比值比3.4,95%置信区间:2.8,4.1)且无症状(比值比12.4,95%置信区间:9.9,15.5)。与传统卫生局诊所相比,图书馆性传播感染筛查项目有效地覆盖了更年轻、无症状且主要为黑人的人群。