Verifying Treatment of Reported Cases of Gonorrhea
BACKGROUND:
Verifying
correct treatment of reported cases of gonorrhea may slow antibiotic
resistance, but verification remains challenging for many sexually transmitted
disease (STD) programs due to increased laboratory case reporting and decreased
provider reporting. The objectives of this study were to document current
reported levels of correct treatment of gonorrhea and to identify approaches
and barriers to verifying treatment.
METHODS:
We
reviewed funding opportunity reports for the Centers for Disease Control and
Prevention's directly funded STD programs and conducted key-informant
interviews to elicit further treatment verification details.
RESULTS:
Among STD
programs containing at least one high-morbidity area, a median of 63.0% of
gonorrhea cases were reported as treated correctly with a Centers for Disease
Control and Prevention-recommended regimen, although the range reported was
wide (11.2%-95.2%). Among cases with some type of documented treatment
information, the proportion treated correctly was higher (median, 82.2%) but
the use of correct treatment was quite variable among STD programs (range,
56.4%-98.5%). Approaches to verifying gonorrhea treatment included modifying
outdated surveillance systems and educating providers about case reporting to
enhance the passive capture of treatment information as well as active
approaches that supported routine and immediate communication with providers
regarding cases missing treatment information. Barriers to treatment
verification included low levels of provider reporting, outdated surveillance
systems, and human and financial resource constraints.
CONCLUSIONS:
Baseline
assessments revealed that levels of correct gonorrhea treatment vary widely,
even after accounting for those cases missing treatment information. Baseline
data can help determine whether the active verification of treatment of all
cases is warranted.
- 1From the Centers for Disease Control and Prevention, Atlanta, GA.
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