Xiong Mingzhou, Lan Lina, Feng Tiejian, Zhao Guanglu, Wang Feng, Hong Fuchang, Wu Xiaobing, Zhang Chunlai, Wen Lizhang, Liu Aizhong, Best John McCulloch, Tang Weiming
STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China Department of Epidemiology and Health Statistics, Public Health School of Central South University, Changsha, Hunan, China.
STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China.
BMJ Open. 2016 Mar 14;6(3):e009629. doi: 10.1136/bmjopen-2015-009629.
To assess the clinical process of gonorrhoea diagnosis and report in China, and to determine the difference of sex ratio between reported incidence based on reporting data and true diagnosis rate based on reference tests of gonorrhoea.
A total of 26 dermatology and sexually transmitted disease (STD) departments, 34 obstetrics-gynaecology clinics and 28 urology outpatient clinics selected from 34 hospitals of Shenzhen regarded as our study sites.
A total of 2754 participants were recruited in this study, and 2534 participants completed the questionnaire survey and provided genital tract secretion specimens. There were 1106 male and 1428 female participants. Eligible participants were patients who presented for outpatient STD care at the selected clinics for the first time in October 2012 were at least 18 years old, and were able to give informed consent.
Untested rate, true-positive rate, false-negative rate and unreported rate of gonorrhoea, as well as reported gonorrhoea incidence sex ratio and true diagnosis sex ratio were calculated and used to describe the results.
2534 participants were enrolled in the study. The untested rate of gonorrhoea among females was significantly higher than that among males (female 88.1%, male 68.3%, p=0.001). The male-to-female sex ratios of untested rate, true-positive rate, false-negative rate and unreported rate were 1:1.3, 1.2:1, 1:1.6 and 1:1.4, respectively. The reported gonorrhoea incidence sex ratio of new diagnosed gonorrhoea was 19.8:1 (male vs female: 87/1106 vs 5/1420), while the true diagnosis sex ratio was 2.5:1 (male vs female: 161/1106 vs 84/1420). These data indicate that the sex ratio of reported gonorrhoea incidence has been overestimated by a factor of 7.9 (19.8/2.5).
We found the current reported gonorrhoea incidence and sex ratios to be inaccurate due to underestimations of gonorrhoea incidence, especially among women.
评估中国淋病诊断和报告的临床过程，确定基于报告数据的报告发病率与基于淋病参考检测的真实诊断率之间的性别比差异。
从深圳34家医院选取26个皮肤科和性传播疾病（STD）科室、34个妇产科诊所和28个泌尿外科门诊作为研究地点。
本研究共招募了2754名参与者，2534名参与者完成了问卷调查并提供了生殖道分泌物标本。其中男性1106名，女性1428名。符合条件的参与者为2012年10月首次到选定诊所进行门诊STD护理、年龄至少18岁且能够给予知情同意的患者。
计算淋病的未检测率、真阳性率、假阴性率和未报告率，以及报告的淋病发病率性别比和真实诊断性别比，并用这些指标描述结果。
2534名参与者纳入研究。女性淋病未检测率显著高于男性（女性88.1%，男性68.3%，p = 0.001）。未检测率、真阳性率、假阴性率和未报告率的男女比例分别为1:1.3、1.2:1、1:1.6和1:1.4。新诊断淋病的报告淋病发病率性别比为19.8:1（男性对女性：87/1106对5/1420），而真实诊断性别比为2.5:1（男性对女性：161/1106对84/1420）。这些数据表明报告的淋病发病率性别比被高估了7.9倍（19.8/2.5）。
我们发现，由于淋病发病率被低估，尤其是在女性中，目前报告的淋病发病率和性别比不准确。
