Partner notification and retesting for Chlamydia trachomatis and Neisseria gonorrhoeae: a case-note review in New Zealand primary care
Sally B. Rose 1 , Susan M. Garrett 1 , Jane Kennedy 2 , Kim Lund 2 , Deborah Hutchings 2 , Caroline Boyle 2 , Susan R. H. Pullon 11 Department of Primary Health Care and General Practice, University of Otago, Wellington South, New Zealand
2 Wellington Sexual Health Service, Te Aro, Wellington, New Zealand
Correspondence to: Sally B. Rose, Department of Primary Health Care and General Practice, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand. Email: sally.rose@otago.ac.nz.
Journal of Primary Health Care 10(2) 132-139 https://doi.org/10.1071/HC17025
Published: 26 April 2018
Journal Compilation © Royal New Zealand College of General Practitioners 2018.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Bacterial sexually transmitted infections (STIs) contribute to a significant burden of ill-health despite being easy to diagnose and treat. STI management guidelines provide clinicians with evidence-based guidance on best-practice case management.
AIM: To determine the extent of adherence to STI management guidelines for partner notification, follow up and testing for reinfection following diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae.
METHODS: Retrospective review of electronic patient records for individuals diagnosed with chlamydia or gonorrhoea in eight primary care clinics in Wellington, New Zealand. At each clinic, 40 clinical records were reviewed (320 in total). Outcome measures were: overall numbers (%) of cases with documented evidence of reason for testing, sexual history, treatment, advice, partner notification and follow up. Partner notification outcomes were: n (%) with evidence of partner notification discussion and n (%) with partners advised, tested and treated. Proportions retested between 6 weeks and 6 months and n (%) positive on retesting were also determined.
RESULTS: Presenting features and treatment were generally well documented. Recent sexual history including number of partners was documented for half of cases reviewed (159/320). Partner notification discussion was documented for 74% (237/320) of cases, but only 24.4% (78/320) had documentation on numbers of partners notified and 17% (54/320) on numbers of partners treated. Testing for reinfection between 6 weeks and 6 months occurred for 24.7% (79/320), of whom 19% (15/79) re-tested positive.
CONCLUSIONS: This research suggests there are gaps in important aspects of patient care following bacterial STI diagnosis – a factor that may be perpetuating our high rates of infection. A more systematic approach will be needed to ensure people diagnosed with an STI receive the full cycle of care in line with best practice guidelines.
KEYWORDS: Sexually transmitted infections, Chlamydia trachomatis, Neisseria gonorrhoea, Clinical guidelines, Partner notification, Patient care.
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