More Screening or More Disease? Gonorrhea Testing and Positivity Patterns Among Men in 3 Large Clinical Practices in Massachusetts, 2010-2017.
More Screening or More Disease? Gonorrhea Testing and Positivity Patterns Among Men in 3 Large Clinical Practices in Massachusetts, 2010-2017.
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更多筛查还是更多疾病？
DOI：
10.1093/cid/ciaa066
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Klompas
中科院分区：
文献类型：
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作者：
Willis,SarahJ;Elder,Heather;Cocoros,Noelle;Young,Jessica;Marcus,JuliaL;Eberhardt,Karen;Callahan,Myfanwy;Herrick,Brian;Weiss,Michelle;Hafer,Ellen;Erani,Diana;Josephson,Mark;Llata,Eloisa;Flagg,ElaineW;Hsu,KatherineK;Klompas
2009-2017年期间，美国淋病诊断率增加了75%，主要是男性。目前尚不清楚男性的增加是由于更多的筛查，疾病患病率的增加，还是两者兼而有之。我们试图评估马萨诸塞州男性淋病检测模式和阳性的变化。方法纳入2010-2017年3个临床实践组接受治疗的男性（年龄≥15岁）。我们计算了淋病检测≥1项的男性和阳性结果≥1项的男性的年百分比。使用对数二项回归模型来检查这些结果的趋势。我们调整了可能影响检测偏好和淋病概率的临床和人口统计学特征。结果平均每年有306348名男性临床就诊。从2010年（3.1%）到2017年（6.4%），进行≥1次淋病检测的男性显著增加（调整后的年风险比为1.12；95%可信区间为1.12 - 1.13）。检测结果≥1例阳性的男性比例显著增加（尽管增幅较小）（2010年为1.0%，2017年为1.5%；调整后的年风险比为1.07；95%置信区间为1.04-1.09）。结论：我们估计，2010年至2017年，淋病检测≥1次的男性和淋病检测结果≥1阳性的男性的年百分比显著增加。这些结果表明，观察到的淋病发病率的增加可以通过筛查和淋病流行的增加来解释。
BackgroundGonorrhea diagnosis rates in the United States increased by 75% during 2009–2017, predominantly in men. It is unclear whether the increase among men is being driven by more screening, an increase in the prevalence of disease, or both. We sought to evaluate changes in gonorrhea testing patterns and positivity among men in Massachusetts.MethodsThe analysis included men (aged ≥15 years) who received care during 2010–2017 in 3 clinical practice groups. We calculated annual percentages of men with ≥1 gonorrhea test and men with ≥1 positive result, among men tested. Log-binomial regression models were used to examine trends in these outcomes. We adjusted for clinical and demographic characteristics that may influence the predilection to test and probability of gonorrhea disease.ResultsOn average, 306 348 men had clinical encounters each year. There was a significant increase in men with ≥1 gonorrhea test from 2010 (3.1%) to 2017 (6.4%; adjusted annual risk ratio, 1.12; 95% confidence interval, 1.12–1.13). There was a significant, albeit lesser, increase in the percentage of tested men with ≥1 positive result (1.0% in 2010 to 1.5% in 2017; adjusted annual risk ratio, 1.07; 95% confidence interval, 1.04–1.09).ConclusionsWe estimated significant increases in the annual percentages of men with ≥1 gonorrhea test and men with ≥1 positive gonorrhea test result between 2010 and 2017. These results suggest that observed increases in gonorrhea rates could be explained by both increases in screening and the prevalence of gonorrhea.