Evaluation of surveillance system changes to improve detection of disseminated gonococcal infections in Virginia, 2018–2021
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Evaluation of surveillance system changes to improve detection of disseminated gonococcal infections in Virginia, 2018–2021



Public Access Version Available on: March 01, 2025, 12:00 AM
Please check back on the date listed above.
  • English

  • Details:

    • Alternative Title:
      Sex Transm Dis
    • Description:
      Background:

      Disseminated gonococcal infection (DGI), a complication of untreated gonorrhea, is rarely reported through routine surveillance. We sought to improve local surveillance system capacity to estimate and monitor the incidence of DGI in Virginia.

      Methods:

      We modified surveillance protocols to identify possible DGI cases using information extracted from gonorrhea case reports and performed provider follow-up using standardized case report forms to confirm DGI diagnosis and collect clinical information. Suspect cases included those with a laboratory report indicating sterile site of specimen collection (e.g. blood, synovial fluid) and/or intravenous (IV) treatment. We performed descriptive analyses to summarize characteristics of suspect and confirmed DGIs and estimated incidence.

      Results:

      After piloting protocols in 2018–2019, we identified 405 suspect DGI cases from 29,294 gonorrhea cases reported in 2020–21 (1.4%). We initiated investigations for 298 (73.6%) of the suspect cases, received provider responses for 105 (25.9%), and confirmed 19 (4.7%) DGI cases. Positive laboratory reports from non-mucosal sites were the most reliable predictor of confirmed DGI status, but most were not confirmed as DGI even when provider follow-up was successful. The confirmed and estimated incidence of DGI was 0.06% and 0.22% respectively. Sixteen (84%) of the confirmed cases were over 25 years of age, 3 (16%) were HIV-positive, and approximately half were male and non-Hispanic black. The majority (15, 74%) were hospitalized, and common manifestations included septic arthritis and bacteremia.

      Conclusions:

      We improved surveillance for DGI in Virginia while incurring minor programmatic costs. Additional efforts to improve the completeness and quality of surveillance data for DGI are needed.

    • Pubmed ID:
      38133574
    • Pubmed Central ID:
      PMC10948019
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