马里兰州巴尔的摩市社区医疗服务提供者对淋病和早期梅毒的治疗实践

Gonorrhea and Early Syphilis Treatment Practices Among Community Health Care Providers in Baltimore City, Maryland.

作者信息

Padiernos Renee, Thornton Nicole, Muvva Ravikiran, Marcell Arik V, Jennings Jacky M, Schumacher Christina M

机构信息

From the University of California Berkeley School of Public Health, Berkeley, CA.

Center for Child and Community Health Research, Department of Pediatrics, Johns Hopkins School of Medicine.

出版信息

Sex Transm Dis. 2025 Mar 1;52(3):154-161. doi: 10.1097/OLQ.0000000000002098. Epub 2024 Nov 7.

DOI:10.1097/OLQ.0000000000002098

PMID:39508483

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11794021/

Abstract

BACKGROUND

Ensuring patients receive appropriate (Centers for Disease Control and Prevention-recommended) and prompt (≤14 days of specimen collection) treatment is critical to decrease gonorrhea and early syphilis (ES) incidence. The objectives were to (1) quantify treatment performance among community health care providers (CHPs), (2) compare CHP treatment performance to local health department goals, and (3) describe variation in treatment performance by CHP characteristics in Baltimore City, Maryland.

METHODS

Surveillance data for gonorrhea and ES diagnoses reported between January 2018 and December 2019 were used. Treatment performance measures were calculated for each CHP (gonorrhea: 171 CHPs; ES: 122 CHPs). Measures were (1) percent treated among all diagnoses (goal: ≥90%), (2) percent appropriately treated among diagnoses treated (goal: ≥90% gonorrhea, ≥95% ES), and (3) percent promptly treated among diagnoses appropriately treated (goal: ≥85%). Treatment performance measures and achievement of goals were compared across CHP characteristics.

RESULTS

For gonorrhea, median percent treated, appropriately treated, and promptly treated were 71.4%, 95.0%, and 100.0%, respectively; 29.8% met treated goals. The majority achieved appropriately treated (62.9%) and promptly treated (76.8%) goals. Community health care practices reporting high (vs. low) volume of gonorrhea diagnoses less frequently achieved percent-treated goals (12.2% vs. 35.4%, P = 0.008). Median value for all ES treatment performance measures was 100.0%. Most achieved treated (90.2%) and appropriately treated (95.9%) goals. Less than half (49.2%) achieved the promptly treated goal. Community health care practices reporting high (vs. low) volumes of ES less frequently achieved promptly treated goals (33.3% vs. 54.4%, P = 0.045).

CONCLUSIONS

Substantial gaps in reporting gonorrhea treatment and prompt ES treatment were observed. Practice-level interventions to facilitate reporting gonorrhea treatment and provide prompt ES treatment are needed.

摘要

背景

确保患者接受适当的（疾病控制与预防中心推荐的）且及时的（标本采集后≤14天）治疗对于降低淋病和早期梅毒（ES）发病率至关重要。目标是：（1）量化社区医疗服务提供者（CHP）的治疗表现；（2）将CHP的治疗表现与当地卫生部门的目标进行比较；（3）描述马里兰州巴尔的摩市CHP特征在治疗表现方面的差异。

方法

使用2018年1月至2019年12月期间报告的淋病和ES诊断监测数据。计算每个CHP的治疗表现指标（淋病：171个CHP；ES：122个CHP）。指标包括：（1）所有诊断中接受治疗的百分比（目标：≥90%）；（2）接受治疗的诊断中接受适当治疗的百分比（目标：淋病≥90%，ES≥95%）；（3）接受适当治疗的诊断中接受及时治疗的百分比（目标：≥85%）。比较不同CHP特征的治疗表现指标及目标达成情况。

结果

对于淋病，接受治疗的百分比、接受适当治疗的百分比和接受及时治疗的百分比中位数分别为71.4%、95.0%和100.0%；29.8%达到了治疗目标。大多数达到了接受适当治疗（62.9%）和接受及时治疗（76.8%）的目标。报告淋病诊断数量多（与少相比）的社区医疗服务机构较少达到接受治疗的百分比目标（12.2%对35.4%，P = 0.008）。所有ES治疗表现指标的中位数为100.0%。大多数达到了接受治疗（90.2%）和接受适当治疗（95.9%）的目标。不到一半（49.2%）达到了接受及时治疗的目标。报告ES数量多（与少相比）的社区医疗服务机构较少达到接受及时治疗的目标（33.3%对54.4%，P = 0.045）。