title: Use of expedited partner therapy among chlamydia cases diagnosed at an urban Indian health centre, Arizona.
abstract: Chlamydia cases diagnosed in the women's clinic were more likely to receive expedited partner therapy (EPT) and to be re-tested as compared with urgent and emergent care settings. Fewer re-infections occurred among patients who received EPT. Disproportionate rates of chlamydia occur among American Indian (AI) populations. To describe use of EPT among chlamydia cases diagnosed at an urban Indian Health Service (IHS) facility in Arizona, health records were used to extract confirmed cases of chlamydia diagnosed between January 2009 and August 2011. Medical records of 492 patients diagnosed with chlamydia were reviewed. Among the 472 cases who received treatment, 246 (52%) received EPT. Receipt of EPT was significantly associated with being female (odds ratio (OR) 2.1, 1.03-4.4, P < 0.001) and receipt of care in the women's clinic (OR 9.9, 95% CI 6.0-16.2) or in a primary care clinic (OR 2.4, 95% CI 1.1-5.1). Compared with those receiving care in the women's clinic, the odds of receipt of EPT were significantly less in those attending the urgent/express care clinic (OR 0.1, 95% CI 0.06-0.2), and the emergency department (OR 0.1, 95% CI 0.05-0.2). Among treated patients who underwent re-testing (N = 323, 68% total treated) re-infection was less common among those that received EPT (13% versus 27%; OR 0.5, 95% CI 0.3-0.9). In this IHS facility, EPT was protective in preventing chlamydia re-infection. Opportunities to expand the use of EPT were identified in urgent and emergent care settings.
authors: Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, GA, USA. MDT7@CDC.GOV
authors: M M
authors: MM
authors: Taylor
authors: B
authors: B
authors: Reilley
authors: M
authors: M
authors: Yellowman
authors: L
authors: L
authors: Anderson
authors: L
authors: L
authors: de Ravello
authors: S
authors: S
authors: Tulloch
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001130:Arizona; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D016358:Contact Tracing; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D015999:Multivariate Analysis; D012307:Risk Factors; D012747:Sexual Partners; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D016549:United States Indian Health Service / Q000458:organization & administration; D014505:Urban Population; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: American Indian/Alaska Native; STD; chlamydia; expedited partner therapy (EPT); patient delivered partner therapy; screening; sexually transmitted infection; treatment; women's health
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