Abstract
Background
The incidence rates of Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (GC) in Saskatoon Health Region are approximately double the national average. A descriptive study was designed to try to determine why.
Methods
The objectives of the study were: 1) to determine whether or not the introduction of a new detection method that is less invasive and more sensitive led to more tests being ordered and a higher percentage of positive cases; 2) to determine what percentage of physicians and STI clinic nurses notified Public Health within 72 hours of suspected Ct or GC; 3) to determine what percentage of physicians and STI clinic nurses listed sexual contact information; and 4) to compare recurrence rates between patients treated by physicians and STI clinic nurses.
Results
The number of tests ordered for Ct and GC increased substantially from 10,425 in 1998 to 28,885 in 2003, while the percentage of positive cases decreased from 7.2% to 3.6%. Only 1.3% of physicians and 9.1% of STI clinic nurses notified Public Health within 72 hours of a suspected case. 51.2% of physicians listed sexual contact information in comparison to 85.4% of STI clinic nurses. Recurrence rates of Ct or GC within one year of initial treatment were 26% lower for patients treated by STI clinic nurses (5.7%) than for physicians (7.2%).
Conclusions
There is a need for additional education for health care providers in the management of sexually transmitted infections in Saskatoon Health Region.
MeSH terms: Chlamydia trachomatis, Neisseria gonorrhoeae, public health, management
Résumé
Contexte
Les taux d’incidence de Chlamydia trachomatis (Ct) et de Neisseria gonorrhoeae (GC) dans le district de santé de Saskatoon sont environ le double de la moyenne nationale. Nous avons mené une étude descriptive pour tenter d’expliquer ce phénomène.
Méthode
L’étude avait les objectifs suivants: 1) déterminer si l’introduction d’une nouvelle méthode de dépistage, moins effractive et plus sensible, a entraîné ou non une augmentation des tests prescrits et du pourcentage de tests positifs; 2) déterminer le pourcentage des médecins et des infirmières de cliniques d’ITS ayant avisé la santé publique des cas suspects de Ct ou de GC dans un délai de 72 heures; 3) déterminer le pourcentage des médecins et des infirmières de cliniques d’ITS ayant indiqué les coordonnées des contacts sexuels des cas; et 4) comparer les taux de récurrence chez les patients traités par les médecins et par les infirmières de cliniques d’ITS.
Résultats
Le nombre de tests de dépistage de Ct et de GC prescrits a considérablement augmenté entre 1998 et 2003 (de 10 425 à 28 885), mais le pourcentage de tests positifs a diminué, passant de 7,2 % à 3,6 %. À peine 1,3 % des médecins et 9,1 % des infirmières de cliniques d’ITS ont avisé la santé publique des cas suspects dans un délai de 72 heures. Un peu plus de la moitié (51,2 %) des médecins ont indiqué les coordonnées des contacts sexuels, contre 85,4 % des infirmières de cliniques d’ITS. Les taux de récurrence de Ct ou de GC moins d’un an après le traitement initial étaient inférieurs de 26 % chez les patients traités par les infirmières de cliniques d’ITS que chez les patients traités par les médecins (5,7 % contre 7,2 %).
Conclusion
Les dispensateurs de soins du district de santé de Saskatoon auraient besoin d’une formation complémentaire sur la gestion des infections transmises sexuellement.
References
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