Journal article
Chlamydia and Gonorrhea Screening in United States Emergency Departments
The Journal of emergency medicine, Vol.44(2), pp.558-567
02/2013
DOI: 10.1016/j.jemermed.2012.08.022
PMID: 23102593
Abstract
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are the most commonly reported notifiable diseases in the United States, with annual reported cases exceeding 1.2 million and estimated costs exceeding $1.2 billion. Reported Emergency Department (ED) prevalence rates for CT and GC for adolescents and young adults range from 0.9% to 8.1%.
Our aim was to evaluate the burden of CT/GC infection in ED patients, assess the extent of associated under- and overtreatment, and investigate mechanisms whereby ED screening can be feasible.
We performed a systematic review of the time period from 1995 to 2010.
Positivity rates for ED patients are comparable with other high-risk populations, and sufficient for selected screening to be cost-effective. Unfortunately, ED patient follow-up is notoriously difficult, and clinicians frequently must choose to either delay treatment until laboratory confirmation or presumptively treat based on presenting symptoms and clinical diagnosis. This results in high rates of both undertreatment (i.e., not treating those infected) and overtreatment (i.e., treating those who are infection-free). Incorrect on-the-spot treatment decisions can result in potentially infected future partners and lack of follow-up treatment, or unnecessary treatment and personal stress associated with improper diagnosis.
ED clinician activities are frequently symptom-driven, and screening nonsymptomatic patients presents a major barrier. Educating ED clinicians on the topics of CT/GC epidemiology, sample collection, and analysis will enable them to address the risks in their presenting populations. Collaboration with health department partners for sample analysis, cost-sharing, and patient follow-up can make routine screening feasible and enable EDs to become more important partners in intervention programs.
Details
- Title: Subtitle
- Chlamydia and Gonorrhea Screening in United States Emergency Departments
- Creators
- Wiley D Jenkins - Research and Program Development, Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, IllinoisWhitney Zahnd - Center for Clinical Research, Southern Illinois University School of Medicine, Springfield, IllinoisRegina Kovach - Division of Emergency Medicine, Southern Illinois University School of Medicine, Springfield, IllinoisPatricia Kissinger - Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Resource Type
- Journal article
- Publication Details
- The Journal of emergency medicine, Vol.44(2), pp.558-567
- DOI
- 10.1016/j.jemermed.2012.08.022
- PMID
- 23102593
- NLM abbreviation
- J Emerg Med
- ISSN
- 0736-4679
- eISSN
- 2352-5029
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 02/2013
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984214797202771
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