title: Positive screening tests for gonorrhea and chlamydial infection fail to lead consistently to treatment of patients attending a sexually transmitted disease clinic.
abstract: OBJECTIVE
  Patients attending sexually transmitted disease (STD) clinics are frequently screened for gonorrhea and chlamydial infection. To determine the efficiency of these screening efforts as a component of STD control, we evaluated treatment outcomes of patients with positive cultures who had not received presumptive treatment at their initial visit.
  
  
  OBJECTIVE
  To determine the treatment outcomes of patients screened for STDs who have positive test results.
  
  
  METHODS
  Retrospective chart review of the computerized medical record.
  
  
  RESULTS
  Between January 1, 1994 and June 30, 1995, 24,823 patients were tested for gonorrhea, of whom 19.3% (4791) had positive cultures. Of patients with positive gonorrhea cultures, 564 (11.8%) had positive screening cultures and did not receive therapy at the time of evaluation. Similarly, screening chlamydial cultures were positive in 1539 (10.9%) of 14,162 patients screened for chlamydial infection. Forty-four percent (677) of these did not receive presumptive treatment for chlamydial infection at their initial visit. Overall, 20% of patients with positive cultures failed to return to the clinic for treatment within 30 days of screening. Of those who did return, 30% did so only after at least 2 weeks had elapsed.
  
  
  CONCLUSIONS
  A substantial proportion of patients with positive screening tests for gonorrhea and chlamydial infection fail to comply with follow-up recommendations and thus are likely to remain infectious. Methods must be sought to enhance patient compliance with follow-up of test results and treatment if indicated.
authors.affiliation: Department of Medicine, University of Alabama, Birmingham 35294-0006, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Schwebke
authors.forename: R
authors.initials: R
authors.lastname: Sadler
authors.forename: J M
authors.initials: JM
authors.lastname: Sutton
authors.forename: E W
authors.initials: EW
authors.lastname: Hook
mesh_terms: D000359:Aftercare / Q000592:standards*; D000554:Ambulatory Care Facilities; D002690:Chlamydia Infections / Q000188:drug therapy*; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D010349:Patient Compliance; D011634:Public Health; D012189:Retrospective Studies; D016896:Treatment Outcome