Map of sexually transmitted disease care in Spanish emergency departments

Miró, Òscar; Miró, Elisabet; García-Lamberechts, E J; Ordozgoiti, Alberto Villamor; Castillo, Juan González del

doi:10.37201/req/051.2021

Cited by 1 publication

(3 citation statements)

References 13 publications

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“…U.S. studies show that 1.3/1,000 of the diagnoses recorded in emergency care are for an STI [ 57 ]. A recent Spanish study conducted in 250 hospital emergency departments (ED), with a population coverage of around 45.7 million people and 19.4 million attendances, showed that approximately 71,000 of those attendances corresponded to a suspected STI, which means an incidence of 3.7/1,000 in our country [ 58 ]. A noteworthy aspect of this study is that only 36.4% of Spanish hospital EDs have a therapeutic approach protocol for STI, which is more frequent in large hospitals and in hospital EDs with a high influx of patients [ 58 ].…”

Section: What Is the Burden Of Sti In The Emergency Department?mentioning

confidence: 99%

“…A recent Spanish study conducted in 250 hospital emergency departments (ED), with a population coverage of around 45.7 million people and 19.4 million attendances, showed that approximately 71,000 of those attendances corresponded to a suspected STI, which means an incidence of 3.7/1,000 in our country [ 58 ]. A noteworthy aspect of this study is that only 36.4% of Spanish hospital EDs have a therapeutic approach protocol for STI, which is more frequent in large hospitals and in hospital EDs with a high influx of patients [ 58 ]. The protocolization of STI in the ED is important for 5 reasons: 1) clinical protocols improve the quality of care; 2) STI are a public health problem so their proper management has implications not only for the patient; 3) sample collection, transport and processing are especially important in some frequent STI such as gonococcal infection, as Neisseria gonorrhoeae is very sensitive to environmental conditions; 4) the successive emergence of antibiotic resistance to gonococcus has forced frequent modifications of empirical treatment guidelines for STI worldwide [ 59 ]; and 5) ensuring subsequent follow-up is important in order to ensure clinical cure, screen for other STI, interrupt the chain of transmission and implement preventive and sexual health promotion measures.…”

Section: What Is the Burden Of Sti In The Emergency Department?mentioning

confidence: 99%

“…The protocolization of STI in the ED is important for 5 reasons: 1) clinical protocols improve the quality of care; 2) STI are a public health problem so their proper management has implications not only for the patient; 3) sample collection, transport and processing are especially important in some frequent STI such as gonococcal infection, as Neisseria gonorrhoeae is very sensitive to environmental conditions; 4) the successive emergence of antibiotic resistance to gonococcus has forced frequent modifications of empirical treatment guidelines for STI worldwide [ 59 ]; and 5) ensuring subsequent follow-up is important in order to ensure clinical cure, screen for other STI, interrupt the chain of transmission and implement preventive and sexual health promotion measures. Seventy percent of EDs frequently or almost always perform exudates for etiological diagnosis, 44% STI serology and 35% HIV serology [ 58 ].…”

Section: What Is the Burden Of Sti In The Emergency Department?mentioning

confidence: 99%

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Sexually transmitted infections in Spain: Current status

Del Romero,

Moreno Guillén,

Rodríguez-Artalejo

et al. 2023

Rev Esp Quimioter

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Sexually Transmitted Infections (STI) are a major public health problem. The problems inherent to their diagnosis, treatment and prevention have to do not only with their nature, but also with organizational issues and overlapping competencies of the different health authorities in Spain. The real situation of STI in Spain, at present, is poorly known. For this reason, the Scientific Committee on COVID and Emerging Pathogens of the Illustrious Official College of Physicians of Madrid (ICOMEM) has formulated a series of questions on this subject which were distributed, not only among the members of the Committee, but also among experts outside it. The central health authorities provide very high and increasing figures for gonococcal infection, syphilis, Chlamydia trachomatis infection and lymphogranuloma venereum (LGV). Both HIV infection and Monkeypox are two important STI caused by viruses in our environment, to which it should be added, mainly, Herpes simplex virus (HSV) and Human papillomavirus (HPV) infections. Emerging microorganisms such as Mycoplasma genitalium pose not only pathogenic challenges but also therapeutic problems, as in the case of N. gonohrroeae. The pathways that patients with suspected STI follow until they are adequately diagnosed and treated are not well known in Spain. Experts understand that this problem is fundamentally managed in public health institutions, and that Primary Care and Hospital Emergency Services, together with some institutions that deal monographically with this problem, are the recipients of most of these patients. One of the most serious difficulties of STI lies in the availability of the microbiological tests necessary for their diagnosis, particularly in this era of outsourcing of microbiology services. Added to this is the increased cost of implementing the latest generation of molecular techniques and the difficulties of transporting samples. It is clear that STI are not diseases to which the entire population is equally exposed and it is necessary to have a better knowledge of the risk groups where to focus the necessary interventions adapted to their characteristics. It should not be forgotten that STI are also a problem in the pediatric age group and that their presence can be a marker of sexual abuse with all that this implies in terms of health care and medicolegal activity. Finally, STI are infections that are associated with a high cost of care for which we have very little information. The possibility of expanding the automatic performance of laboratory tests for STI surveillance through laboratory routines is encountering ethical and legal problems that are not always easy to solve. Spain has created a ministerial area of specific attention to STI and there are plans to improve the diagnosis, treatment and prevention of these problems, but we still lack the necessary evidence on their impact. We cannot forget that these are diseases that transcend the individual and constitute a Public Health problem.

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Section: What Is the Burden Of Sti In The Emergency Department?mentioning

confidence: 99%