title: Gonorrhea reinfection among sexually transmitted disease clinic attendees in Baltimore, Maryland.
abstract: OBJECTIVE
  We hypothesized that an active follow-up program to assess for reinfection after gonorrhea treatment could be a useful disease control strategy.
  
  
  OBJECTIVE
  We evaluated an active follow-up and repeat testing program for all Baltimore sexually transmitted disease clinic patients diagnosed with gonorrhea.
  
  
  METHODS
  From September 2003 to May 2004, all clients with a treated gonorrhea infection were advised to return 3 months later for repeat testing. If clients did not return as scheduled, field outreach was attempted. At follow-up visits, urine was tested for gonorrhea and consenting participants completed a behavioral survey. In addition, we reviewed morbidity records for any intercurrent gonorrhea infections reported during the project period.
  
  
  RESULTS
  Of the 667 participants diagnosed with gonorrhea at baseline, 54 had a gonorrhea reinfection diagnosed for an incidence of 13.8 per 100 person-years. One hundred seventy-eight (27%) either presented for a follow-up visit or were located through field efforts, and of these, 5 (2.8%) had gonorrhea detected on follow-up urine testing. No measured factors had predictive value in identifying gonorrhea reinfection.
  
  
  CONCLUSIONS
  Although reinfection rates were high, we found that field staff intervention to increase follow-up testing rates did not identify a significant amount of repeat infections compared with passive surveillance.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. kyle.bernstein@med.nyu.edu
authors.forename: Kyle T
authors.initials: KT
authors.lastname: Bernstein
authors.forename: Jonathan
authors.initials: J
authors.lastname: Zenilman
authors.forename: Glen
authors.initials: G
authors.lastname: Olthoff
authors.forename: Vincent C
authors.initials: VC
authors.lastname: Marsiglia
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Erbelding
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D015142:Baltimore / Q000453:epidemiology; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D015397:Program Evaluation; D012008:Recurrence; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D014556:Urine / Q000382:microbiology