title: Detecting re-infection in patients after an initial diagnosis of gonorrhoea: is routine recall for re-screening useful?
abstract: To assess the outcome of routine sexually transmitted infection re-screening after a three-month interval in unselected patients diagnosed with gonorrhoea, we sought to assess whether this active approach would result in an increase in the number of people attending clinic and subsequently diagnosed with gonorrhoea re-infection, compared with normal re-presentation rates. A recall group of patients were invited for re-screening three months after their initial diagnosis of gonorrhoea. Permission was sought to send a reminder two weeks prior to their scheduled recall appointment. Comparisons were made with a historical control group of patients with gonorrhoea in the absence of any formal recall. Of the 242 patients in the intervention arm, 96 (40%) re-attended within six months, and 15 (6%) tested gonorrhoea positive. Two hundred and two patients were assessed in the control group, of whom 45 (22%) re-attended within six months, and 13 (6%) tested gonorrhoea positive. Women were more likely than men to re-attend following active recall, but they were not at higher risk of re-attending while re-infected with gonorrhoea. Active recall following a gonorrhoea diagnosis significantly increases re-attendance rates for repeat screening but did not result in an increased number of subsequent gonorrhoea diagnoses.
authors.affiliation: Department of Genitourinary Medicine, Staffordshire and Stoke-on-Trent Partnership NHS Trust, Cobridge Community Health Centre, Stoke-on-Trent, UK Kieran.Fernando@ssotp.nhs.uk.
authors.forename: K A
authors.initials: KA
authors.lastname: Fernando
authors.affiliation: Field Epidemiology Services - West Midlands, Public Health England, Birmingham, UK Public Health, Epidemiology & Biostatistics Home, University of Birmingham, Birmingham, UK.
authors.forename: T
authors.initials: T
authors.lastname: Fowler
authors.affiliation: Department of Genitourinary Medicine, Whittall Street Clinic, University Hospitals Birmingham NHS Trust, Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Harding
authors.affiliation: Department of Genitourinary Medicine, Whittall Street Clinic, University Hospitals Birmingham NHS Trust, Birmingham, UK.
authors.forename: S
authors.initials: S
authors.lastname: Flew
authors.affiliation: Department of Public Health, NHS Warwickshire/Warwickshire County Council, Warwick, UK.
authors.forename: M
authors.initials: M
authors.lastname: Caley
authors.affiliation: Department of Genitourinary Medicine, Whittall Street Clinic, University Hospitals Birmingham NHS Trust, Birmingham, UK.
authors.forename: J
authors.initials: J
authors.lastname: Phattey
authors.affiliation: Department of Genitourinary Medicine, Whittall Street Clinic, University Hospitals Birmingham NHS Trust, Birmingham, UK.
authors.forename: Jdc
authors.initials: J
authors.lastname: Ross
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D012008:Recurrence; D012749:Sexually Transmitted Diseases / Q000175:diagnosis*; D013997:Time Factors
keywords: Gonorrhoea (Neisseria gonorrhoeae); Sexually transmitted infection; prevention; recall; repeat screening; screening