Endemic versus Non-Endemic Gonorrhoea in Stockholm: Results of Contact Tracing

Abstract

The aim of the present study was to characterize endemic versus non-endemic gonorrhoea to identify risk groups for transmission and to evaluate the effects of intensified contact tracing performed by specially trained social workers at venereal clinics. A total of 671 gonorrhoea patients (283 women and 388 men) comprised the study group. Seventy percent of the women and 48% of the men had an endemic infection (P < 0.001). Men without a steady partner had an increased risk of non-endemic infection. A decrease from 75% to 40% was noted in the proportion of endemic infection in Stockholm from the first quarter of the study period (2 years) to the last. Contact tracing resulted in 1.2 identified partners per patient. A total of 736 partners were examined either as a result of contact tracing efforts or because they had sought medical care on their own prior to intervention. Forty-seven percent of these partners were infected, 44% were not infected and 9% were examined outside the study with results unknown to us. The partner notification efforts yielded 161 new untreated cases. Contact tracing of women generated one new case per 4.0 interviewed women and contact tracing of men one new case per 4.3 interviewed men. Interviewing index patients with endemic infection yielded the highest number of new cases. Forty-three percent of the patients were infected outside Stockholm but only a smaller part of these patients spread their infection further into the community.(ABSTRACT TRUNCATED AT 250 WORDS)

Gonorrhoea in Coventry 1991-1994: epidemiology, coinfection and evaluation of partner notification in the STD clinic

“…In contrast, our study showed that those who accepted the interview in the ® rst visit were less likely to default than those who refused the interview. The 1.5 partners per patient identi® ed in the study is similar to other studies, and higher than the 1.2 partners per patient in a prospective study with intensi® ed contact tracing efforts in the Stockholm area 4 . In our study, 0.7 partners per patient were screened and 0.6 partners per patient were known or found to be infected.…”

“…In another UK area 75% were diagnosed and 89% were managed in the clinic 3 , and in Sweden only 50± 78% attended venereal clinics 4 . This may re¯ect the UK public awareness of STD clinic services.…”

Case-Finding Effectiveness of Partner Notification and Cluster Investigation for Sexually Transmitted Diseases/HIV

“…29,30 However, most reports indicate that provider referral, when implemented, accounts for a greater percentage of partners actually notified than patient referral 31 39,40 However, PN for syphilis in Louisiana between 1993 and 1996 showed essentially uniform yields across different age groups of index cases. 17 Cases' sex also had no relation to yield for STD or HIV PN: the brought-to-treatment index was higher for females in 6 of 12 studies that allowed such comparisons (appendix in online technical report).…”

Effect of Expedited Treatment of Sex Partners on Recurrent or Persistent Gonorrhea or Chlamydial Infection

“…However, partner notification assistance is infrequently provided by health departments in the United States to patients with gonorrhea or chlamydial infection, and when assistance is provided, the process has been relatively inefficient when extended to second-generation sexual contacts. 24,25 Beyond the potential deleterious effects of patient-delivered partner therapy, legal barriers and the uncertain availability of cefixime may inhibit its use. Although commonly used, 17 the legality of patient-delivered partner therapy remains ill-defined in most states, and more widespread use of it or other approaches to expedited treatment of partners may require new laws or administrative rulings.…”