An evaluation of the applicability of quantitative clinical standards for the management of genital chlamydial infection using an electronic database.

A prototype electronic database was designed for use as a retrospective audit tool to provide data that allowed comparison of genital chlamydial infection management performance with a series of quantitative operational consensus standards. However, some of the terms used by the standards require further definition for translation into database fields to improve accuracy and general application as an audit tool. Construction of the database involved differentiation between prior and clinic diagnostic points, as well as a forward contact trail of specific quantitative indicators of contact tracing. More definition is needed of the meaning of diagnosis and contact in the standards. For clinic-diagnosed patients, the time to treatment was mainly dependent on clinical factors, not on the availability of a chlamydial test result. For about one-third of patients (with prior management), several standards cannot be applied because data are not available, and this raises the issue of data sharing between various agencies involved in chlamydial testing. More data from other clinics may help both to test the appropriateness of, and inform, some of the operational standards. The database could be developed as a real-time audit tool for use with electronic patient records.

General practitioners' views on the screening for genital Chlamydia trachomatis infection and partner notification.

A postal survey of general practitioners (GPs) in the East Riding of Yorkshire was undertaken to find out their views about screening for Chlamydia trachomatis infection, the reasons for their inability to screen the high-risk population, facilities available for screening in the primary care setting, treatment regimen and the views about partner notification. Although all GPs had the facilities for chlamydial testing, their views on chlamydial screening differed widely and very few offered opportunistic screening. Most of the GPs would prefer the sexual health clinics (genitourinary medicine [GUM] clinics) to undertake partner notification. Less than half of the GPs surveyed offered the ideal antimicrobial therapy against chlamydial infection, as recommended by the Central Audit Group in Genito-urinary Medicine. This survey shows the necessity to disseminate proper guidelines for the management of uncomplicated C. trachomatis infection in the community. Sexual health clinics should make adequate provision to deal with additional workload resulting from the increased referrals of partners to the clinics when the opportunistic screening is widely provided by the GPs.

HIV testing in Glasgow Genito-Urinary Medicine Clinics 1985-1987.

Between 1 March 1985 and 28 February 1987, 1659 patients attending Glasgow Genito-Urinary Medicine (GUM) Clinics were tested for antibodies to human immunodeficiency virus (HIV). Forty (2.4%) were positive. Thirty-seven of these were homosexual (36/37) or bisexual (1/37) males. The overall prevalence of antibodies to HIV in this group was 3.9% (37/940) and showed no significant increase over the two year period. Following the extensive media campaign in October 1986, the total numbers tested each month rose from an average of around 50, to 144 in December 1986. There was a further rise to 220 in March 1987 coinciding with AIDS week in March 1987. Since then the numbers have again declined. Before the October campaign, 70% of these tested (692/990) were homo/bisexual males. After the campaign the number of heterosexual males and females rose sharply, accounting for 68% of these tested.