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Evaluation of surveillance system changes to improve detection of disseminated gonococcal infections in Virginia, 2018–2021
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3 01 2024
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Source: Sex Transm Dis. 51(3):171-177
[PDF-648.21 KB]
Details:
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Alternative Title:Sex Transm Dis
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Personal Author:
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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.
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Pubmed ID:38133574
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Pubmed Central ID:PMC10948019
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Volume:51
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Issue:3
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