Article Text
Abstract
Background Partner notification (PN) is an essential component of STI control but can be difficult where index cases have multiple casual partners. Guidelines recommend that for gonorrhoea, a minimum of 0.4 contacts/case in large conurbations, and 0.6 contacts/case elsewhere, should be screened. We investigated the effectiveness of newly introduced surveillance codes for monitoring standards of PN in England.
Objectives To investigate the relationship between PN ratios for gonorrhoea and patient socio-demographic characteristics.
Methods Data on PN from the Genitourinary Medicine Clinic Activity Dataset (GUMCAD) were analysed.
Results Reporting on PN began on a rolling basis in 207 GUM clinics during 2011. Provisional data on PN were available from 171 clinics reporting data covering 951 clinic months in total, during which there were 7423 cases and 2749 contacts. In this period, the overall PN ratio for gonorrhoea was 0.37 contacts/case. PN ratios were highest for clinics in non-urban areas (0.42 vs 0.36 in urban areas) but there was no difference between PN ratios in London and the rest of England. PN was most successful for female partners of heterosexual male index cases (0.44 contacts/case). Of those attending as a contact 26% (707/2749) tested positive for gonorrhoea; 31% of females, 22% of heterosexual males and 24% of MSM.
Conclusions Provisional data suggest that, on average, contact to index case ratios for gonorrhoea are below recommended standards but these are likely to vary considerably by clinic. The high prevalence of gonorrhoea among contacts emphasises the importance of PN for case finding and reducing transmission. Further analysis to better understand the strengths and limitations of these data is warranted.