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Gonorrhea surveillance: estimating epidemiologic and clinical characteristics of reported cases using a sample survey methodology.
Sexually Transmitted Diseases 2004;31(4):215-20.
Mark KE, Gunn RA.
Abstract
BACKGROUND: Little is known about the epidemiology of gonorrhea in the United
States, except for basic demographics of reported cases. Knowing the proportion
of reported gonorrhea cases identified through screening, the diagnostic
test used, and patient behavioral risk factors might help to better explain
changes in gonorrhea rates over time. GOAL: The goal of this study was to
implement and evaluate a gonorrhea sample survey surveillance methodology
in San Diego, California. STUDY DESIGN: Healthcare providers caring for a
representative sample of all gonorrhea patients reported during August 16
through October 18, 2001 were interviewed by telephone about patient demographics,
risk factors, and management. RESULTS: The healthcare providers of 248 gonorrhea
patients were contacted; data were obtained on 224 (90%) patients. Major
reasons for testing included symptoms (68%), partner referral (14%), and
screening (12%). Gonococcal culture, DNA probe tests, and nucleic acid amplification
tests were used to diagnose 40%, 34%, and 21% of patients, respectively.
At minimum, 36% of male gonorrhea patients were men who have sex with men
(MSM); MSM with gonorrhea were rarely diagnosed with rectal or pharyngeal
gonorrhea outside of sexually transmitted disease (STD) clinics. Estimated
local resources required to conduct this survey were $12 per completed interview.
CONCLUSION: Healthcare provider telephone interviews regarding recently reported
gonorrhea patients are feasible and can provide important additional information
to STD programs, which could be used to direct intervention strategies and
monitor trends. Ultimately, a national sampling approach could be explored
and incorporated into ongoing gonorrhea surveillance.