ABSTRACT
BACKGROUND AND OBJECTIVES: To obtain patients' perspectives on why only some partners are notified in partner-notification programs, the cornerstone of sexually transmitted disease (STD) control, although low proportions of partners are located and evaluated. GOALS: To describe patterns of partner notification reported by persons with STD infection. STUDY DESIGN: In-depth interviews conducted in Seattle with 60 heterosexual men and women with gonorrhea, chlamydial infection, or nongonoccocal urethritis, and 19 men with gonorrhea reporting sex with men (MSM) were tape recorded, transcribed verbatim, and content analyzed. RESULTS: The typical notification pattern was to notify a main partner but not others. Least likely to be notified were partners perceived as transmitters, contacts preceding the onset of symptoms, the oral sex and anonymous contacts of MSM, one-time partners of men, and incarcerated and former partners of women. Fears among young heterosexual participants included gossip and violence (women). Fears among MSM included rejection. CONCLUSIONS: Partner-notification programs should develop innovative approaches for partners perceived as transmitters, oral-sex only contacts of MSM, and contacts preceding symptom onset.
Subject(s)
Contact Tracing , Disease Transmission, Infectious/prevention & control , Sexually Transmitted Diseases/prevention & control , Sexually Transmitted Diseases/transmission , Adolescent , Adult , Chlamydia Infections/prevention & control , Female , Gonorrhea/prevention & control , Heterosexuality , Homosexuality , Humans , Interviews as Topic , Male , Middle Aged , Surveys and Questionnaires , Urethritis/prevention & control , WashingtonABSTRACT
BACKGROUND & OBJECTIVES: To describe partner notification practices for chlamydial infections among private sector clinicians. STUDY DESIGN: Telephone interviews of clinicians and patients identified through public health case reports in Seattle-King County, August-October 1998. RESULTS: Clinicians reported advising 135 of 150 (90%) patients to notify their sex partners, but knew that all partners of only 26 (17%) patients received treatment. While 71 (57%) clinicians acknowledged ever providing medicine-to a patient to give to a partner, only 6 (4%) so treated a patient about whom they were interviewed. Most (87%) clinicians believed the health department should routinely contact all patients about partner notification. Almost all patients (72/76-95%) reported that their provider had advised them to notify their partners and 59 (78%) stated they did so. Most patients (11/17-65%) who did not notify all of their partners would have been willing to allow their clinician or the heath department to do it for them. CONCLUSION: Private sector clinicians and their patients are generally unaware of chlamydial partner notification outcomes but are receptive to expanded partner notification services.
Subject(s)
Chlamydia Infections , Contact Tracing/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , Adult , Chi-Square Distribution , Data Collection , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Practice Patterns, Physicians'/standards , WashingtonABSTRACT
The resurgence of malaria in Venezuela as an epidemic has caused an increase in the number of cases of this disease. 898 cases were registered in 1962 in contrast to 46,279 cases in 1988. This reality implies that all hospitals will have to face the increase of patients with this disease. Ten cases of malaria have been described and analyzed. These have been chosen for their medical and surgical complications, for which they were admitted to the "Hospital Universitario de Caracas" and "Hospital de Clínicas Caracas". Of these ten cases, eight were acquired in a natural way and two in an induced form. In six cases, the agent was P. falciparum; in three, P. vivax; in one, P. ovale and P.vivax combined. Five of the cases by P.falciparum were resistant to chloroquine, being necessary to treat them with a combination of quinine and other antimalaric drugs. Among the 10 described patients, there were: one case of splenic rupture in malaria by P. vivax, a severe case of anemia in a child with malaria by this same species and a case of relapse produced by P.vivax in another child with an insufficient radical treatment. The usual mistakes are observed in the management of malaria, such as a delay in the diagnosis and inappropriate radical treatment. As conclusion, publication of epidemiological, clinical and parasitological problems which are causing the actual epidemic, is recommended. This will be a guide in the fight against malaria, that must be considered again a national emergency.
