Sexually transmitted disease treatment and return for test of cure of adolescents in a family planning clinic

Smith, Peggy B.; Chacko, Mariam R.; McGill, Laurilynn; Phillips, Lou Ellen

doi:10.1016/0197-0070(91)90041-j

Cited by 9 publications

(4 citation statements)

References 10 publications

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“…10 The low rate of follow up contrasts with a study, performed in a family planning clinic in the United States with a low incidence of STI. 11 Their findings may represent the characteristics of the general population, rather than that of teenagers in particular. Prioritisation did not reduce the number of clients leaving the clinic before being seen, nor did it improve the clinical care received within the clinic.…”

Section: Discussionmentioning

confidence: 98%

News from the frontline: sexually transmitted infections in teenagers attending a genitourinary clinic in south east London

Creighton

Edwards²,

Welch³

et al. 2002

Sexually Transmitted Infections

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Objectives: To define the incidence and characterise the clinical presentation of sexually transmitted infections (STI) in people aged <16 years old attending a genitourinary clinic in south east London. Methods: Cross sectional analysis of clients aged <16 years attending one genitourinary clinic. A subgroup was identified for priority treatment. Data collected included age, reason for presentation, diagnosis, contraceptive use, and adherence to therapy. Diagnoses were compared to the KC60 codes for female attendances of all ages. Results: 144 females and 18 males with a mean age of 15.4 years attended, of whom 49% were symptomatic. Compared to other attenders, clients aged <16 years were significantly more likely to have an STI (64% versus 22%, p <0.00000001); 27 were pregnant (of whom 96% requested a termination of pregnancy); 47% did not return for follow up; and 12% did not adhere to treatment plan. Those diagnosed with an STI were significantly less likely to reattend (p<0.001).Conclusions: There is a high rate of STIs in 16 year olds compared to national figures and to general clinic attenders. Poor contraception is often overlooked within the genitourinary medicine clinic. Young attenders frequently fail to reattend for follow up. Priority treatment did not affect outcome. Further strategies are needed to identify ways to improve young people's access to genitourinary medicine clinics. R ates of infection with Chlamydia trachomatis and Neisseria gonorrhoeae peak among women aged 16-19 years 1 and teenagers with sexually transmitted infections (STI) are more likely than older groups to be reinfected after initial presentation.2 Twenty eight per cent of 16 year olds use no contraception, 3 resulting in the United Kingdom having the highest teenage pregnancy rate in western Europe. 4 These issues are prioritised in the national strategy for sexual health and HIV. 5 South east London has the highest abortion rate in England 6 and treats 14% of the nation's gonorrhoea. 7 The present study is a cross sectional analysis of clients aged <16 years attending a genitourinary medicine clinic in south east London which offers treatment for all sexually transmitted infections (STIs), contraception, and forensic screening.The aims of the study were to define the incidence of STI in clients aged <16 years in south east London, characterise behavioural variables (for example, reason for accessing the clinic, contraceptive use, and adherence to treatment), and observe treatment received in the clinic. METHODSThis is a cross sectional survey of all clients aged <16 years attending the genitourinary medicine clinic at King's College Hospital in March and October 1998. Two separate months were chosen to minimise effects of individual staff members on client treatment. Clients attending repeatedly in this time period were counted once. Cases were identified retrospectively from the clinic database. Data were abstracted from the medical records using a standardised proforma by one investigator. Variables collected include...

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Section: Discussionmentioning

confidence: 98%

News from the frontline: sexually transmitted infections in teenagers attending a genitourinary clinic in south east London

Creighton

Edwards²,

Welch³

et al. 2002

Sexually Transmitted Infections

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“…The reasons behind the low frequency of appropriate follow-up management rates are difficult to elucidate. Previous literature has shown that patients are more likely to receive treatment if a prescription is called in to a pharmacy rather than having to return in-person 18 . In addition, difficulty contacting patients results in a significant proportion of patients not receiving treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Previous literature has shown that patients are more likely to receive treatment if a prescription is called in to a pharmacy rather than having to return in-person. 18 In addition, difficulty contacting patients results in a significant proportion of patients not receiving treatment. Follow-up laboratory testing has been found to occur more frequently in patients enrolled in primary care services and/or who were diagnosed in outpatient clinics rather than in inpatient or emergency department settings.…”

Section: Discussionmentioning

confidence: 99%

Rates of Appropriate Treatment and Follow-Up Testing After a Gonorrhea and/or Chlamydia Infection in an Urban Network of Federally Qualified Health Center Systems

et al. 2022

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Background: Reinfection and partner transmission are common with Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT). We assessed treatment and follow-up laboratory testing for GC and CT and evaluated associations with patient-and system-level factors. Methods:The analysis included positive GC and/or CT nucleic acid amplification test results from patients aged 14 to 24 years at a federally qualified health center system site in Denver, CO, from January 2018 to December 2019. Outcomes assessed include treatment within 14 days, HIV/syphilis testing within 6 months, and repeat GC and CT testing within 2 to 6 months. Bivariate and multivariable regression modeling assessed associated factors.Results: Among 27,168 GC/CT nucleic acid amplification tests performed, 1.8% (484) were positive for GC and 7.8% (2125) were positive for CT. Within the assessed time frames, 87% (2275) of patients were treated, 54.1% (1411) had HIV testing, 50.1% (1306) had syphilis testing, and 39.9% (1040) had GC and CT retesting. Older patients were more likely to receive treatment (adjusted odds ratio 1.13; 95% confidence interval, 1.00-1.27; P = 0.05) than younger patients, whereas males were less likely to receive GC and CT retesting (adjusted odds ratio, 0.19; 95% confidence interval, 0.11-0.33; P < 0.001) than females. Patients treated on the day of testing were less likely to receive follow-up laboratory tests than those treated 2 to 14 days after.Conclusions: Although most patients received antibiotic treatment, only about half received HIV/syphilis testing and less than half received GC and CT retesting. It is critical to find innovative strategies to improve treatment and follow-up management of these infections to decrease complications, reduce transmission, and combat the rising rates of sexually transmitted infections.N eisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) are the 2 most commonly reported sexually transmitted infections (STIs) in the United States, and the prevalence has increased substantially in the past decade. 1 Adolescents and young adults aged 14 to 24 years make up half of the new STI diagnoses each year despite comprising only one-quarter of the sexually active population. 2 In addition, antibiotic-resistant GC infection is listed on the Centers for Disease Control and Prevention's (CDCs) urgent threat list. 3,4 Untreated infections result in considerable morbidity and may lead to infertility in women. 5,6 Thus, prompt treatment is imperative to prevent complications and to reduce disease transmission. 7,8 Patients with GC and/or CT also have an increased risk of human immunodeficiency virus (HIV) transmission, and they may not use condoms consistently; thus, HIV testing is recommended for individuals who have GC and/or CT infections. 7,8 Given escalating rates of syphilis in Denver, CO, routine syphilis testing after a GC and/or CT infection is recommended based on national guidelines recommending testing for syphilis in highrisk individuals (residence in high-prevalence areas or other risk fact...

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“…7'* Adolescents are particularly at risk for poor compliance with prenatal care and medication administration and for reinfection with C. trachomat/S. [9][10][11] There are no studies that have examined the effectiveness of erythromycin during pregnancy in a purely adolescent population.…”

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confidence: 99%

Chlamydia trachomatis Infections: Implications for Pregnant Adolescents and Their Infants

Melzer-Lange

Good

Hennes

1994

Infectious Diseases in Obstetrics and Gynecology

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were followed for episodes of conjunctivitis, pneumonia, and wheezing during their 1st year of life.Results: Ninety mother/infant pairs were followed during the study period. Twenty-eight mothers (31%) had positive enzyme assay tests and all received erythromycin therapy. Nasopharyngeal cultures were obtained from 60 (67%) infants; all were negative. There were no significant differences in general characteristics, development of conjunctivitis (relative risk 1.27), wheezing (relative risk 0.91), or pneumonia (relative risk 1.12) between infants born to adolescents in either group. Conclusions

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Sexually transmitted disease treatment and return for test of cure of adolescents in a family planning clinic

Cited by 9 publications

References 10 publications

News from the frontline: sexually transmitted infections in teenagers attending a genitourinary clinic in south east London

News from the frontline: sexually transmitted infections in teenagers attending a genitourinary clinic in south east London

Rates of Appropriate Treatment and Follow-Up Testing After a Gonorrhea and/or Chlamydia Infection in an Urban Network of Federally Qualified Health Center Systems

Chlamydia trachomatis Infections: Implications for Pregnant Adolescents and Their Infants

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