Characteristics of Reported Gonorrhea Diagnoses During The COVID-19 Pandemic Compared With Pre-COVID-19 Pandemic, Baltimore City, Maryland.
Characteristics of Reported Gonorrhea Diagnoses During The COVID-19 Pandemic Compared With Pre-COVID-19 Pandemic, Baltimore City, Maryland.
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DOI：
10.1097/olq.0000000000001750
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发表时间：
2023-04-01
影响因子：
3.1
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中科院分区：
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对马里兰州巴尔的摩市报告淋病诊断的个体特征的分析显示，与COVID-19大流行前相比，COVID-19大流行期间没有迹象表明有症状个体的病例确定增加。由于COVID-19缓解措施导致的性健康服务中断可能减少了淋病筛查，并使病例确定偏向于有症状的个体。我们评估了在1个淋病持续传播的城市，在大流行期间与大流行前报告的淋病病例中报告的症状和其他特征的变化。使用了2018年3月至2021年9月期间向巴尔的摩市卫生局报告的淋病病例随机样本收集的加强监测数据。Logistic回归评估了不同诊断时期（大流行期间：2020年3月至2021年9月;大流行前：2018年3月至2019年9月）病例特征的差异。分析包括2750例（大流行期间1090例，大流行前1660例）淋病病例，代表11,904例报告病例。在大流行期间与大流行前相比，性健康诊所报告的病例比例更低（8.8%对23.2%），急诊科/紧急护理中心报告的病例比例更高（23.3%对11.9%）。调整诊断提供者，男性尿道感染病例较少（校正比值比[aOR]，0.65; 95%置信区间[CI]，0.55-0.77），年龄<18岁（aOR，0.64; 95% CI，0.47-0.89），女性（aOR，0.84; 95%CI，0.71-0.99），有保险的病例（aOR，1.85; 95% CI，1.40-2.45），人类免疫缺陷病毒感染者与大流行前相比，大流行期间更常报告淋病病史（aOR，1.43; 95% CI，1.12-1.83）或近期（≤12个月）淋病病史（aOR，1.25; 95% CI，1.02-1.53）。报告的症状和同一天/经验性治疗在不同时期没有差异。我们观察到在大流行期间诊断的病例与大流行前相比，报告的症状没有变化。有保险、感染人类免疫缺陷病毒或近期有淋病病史的人报告诊断的频率增加，表明大流行期间淋病传播率高的人群在获得护理和寻求护理行为方面存在差异。
An analysis of characteristics of individuals with reported gonorrhea diagnoses in Baltimore City, Maryland, showed no indication of increased case ascertainment among symptomatic individuals during COVID-19 pandemic compared with pre – COVID-19 pandemic. Sexual health service disruptions due to COVID-19 mitigation measures may have decreased gonorrhea screening and biased case-ascertainment toward symptomatic individuals. We assessed changes in reported symptoms and other characteristics among reported gonorrhea cases during pandemic versus prepandemic periods in 1 city with persistent gonorrhea transmission. Enhanced surveillance data collected on a random sample of gonorrhea cases reported to the Baltimore City Health Department between March 2018 and September 2021 was used. Logistic regression assessed differences in case characteristics by diagnosis period (during pandemic: March 2020–September 2021; prepandemic: March 2018–September 2019). Analyses included 2750 (1090 during pandemic, 1660 prepandemic) gonorrhea cases, representing 11,904 reported cases. During pandemic versus prepandemic, proportionally fewer cases were reported by sexual health clinics (8.8% vs 23.2%), and more frequently reported by emergency departments/urgent care centers (23.3% vs 11.9%). Adjusting for diagnosing provider, fewer cases who were men with urethral infections (adjusted odds ratio [aOR], 0.65; 95% confidence interval [CI], 0.55–0.77), aged <18 years (aOR, 0.64; 95% CI, 0.47–0.89), and women (aOR, 0.84; 95% CI, 0.71–0.99) were reported, and cases with insurance (aOR, 1.85; 95% CI, 1.40–2.45), living with human immunodeficiency virus (aOR, 1.43; 95% CI, 1.12–1.83), or recent (≤12 months) gonorrhea history (aOR, 1.25; 95% CI, 1.02–1.53) were more frequently reported during pandemic versus prepandemic. Reported symptoms and same-day/empiric treatment did not differ across periods. We observed no changes in reported symptoms among cases diagnosed during pandemic versus prepandemic. Increased frequency of reported diagnoses who were insured, living with human immunodeficiency virus, or with recent gonorrhea history are suggestive of differences in care access and care-seeking behaviors among populations with high gonorrhea transmission during the pandemic.