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Estimating gonorrhoea prevalence in young heterosexual men and women attending community-based sexual health services to inform decisions on gonorrhoea testing
- Source :
- Epidemiol Infect
- Publication Year :
- 2017
- Publisher :
- Cambridge University Press, 2017.
-
Abstract
- SUMMARYIn England, dual tests detecting chlamydia and gonorrhoea are used in specialist and community-based sexual health services (SHSs). Test performance is poor when prevalence is low, therefore UK national guidelines recommend against opportunistic gonorrhoea screening unless there is a clear local public health need. While surveillance data on gonorrhoea prevalence is comprehensive in specialist SHSs, it is sparse in community SHSs. We aimed to estimate gonorrhoea prevalence in heterosexual men and women aged 15–24 attending community SHSs to inform testing care pathways. We used linear and quadratic regression to model the relationship between prevalence in community and specialist SHSs in local authorities (LAs) with available surveillance data. We applied best-fitting models to predict prevalence in community SHSs in remaining LAs. Data from community SHSs were available for 102/326 LAs. There was a weak positive association between gonorrhoea prevalence in community and specialist SHSs in corresponding LAs within (R2 = 0·13, P = 0·058) and outside (R2 = 0·07, P = 0·02) London. Applying best-fitting models, we estimated a median gonorrhoea prevalence of 0·5% (mean 0·6%; range 0·2%–2·7%) in heterosexuals attending community SHSs. Despite some unexplained variation, our analyses suggest gonorrhoea prevalence in young heterosexuals attending community SHSs is below 1% in most English LAs. Our findings re-inforce the current national guidelines that recommend care pathways for gonorrhoea testing in community SHSs include confirmatory testing to reduce the risk of misdiagnosis and inappropriate management.
- Subjects :
- Gerontology
Male
medicine.medical_specialty
Adolescent
Epidemiology
03 medical and health sciences
Gonorrhea
Young Adult
0302 clinical medicine
medicine
Prevalence
Humans
030212 general & internal medicine
Community Health Services
Heterosexuality
Reproductive health
Community based
030505 public health
Chlamydia
business.industry
Public health
Incidence (epidemiology)
medicine.disease
Original Papers
Neisseria gonorrhoeae
Infectious Diseases
Reproductive Health
England
Family medicine
Population Surveillance
Test performance
Female
0305 other medical science
business
Subjects
Details
- Language :
- English
- ISSN :
- 09502688
- Database :
- OpenAIRE
- Journal :
- Epidemiol Infect
- Accession number :
- edsair.doi.dedup.....54b3195531dbd5eb6bc74f4602f8ab7b