OPPORTUNISTIC SCREENING FOR STD IN EMERGENCY DEPARTMENTS

在急诊室对性传播疾病进行机会性筛查

• 批准号: 6212411
• 负责人: EDWARD W HOOK
• 金额: $ 18.33万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-09-01 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6212411
• 关键词: Chlamydia trachomatis; Neisseria gonorrhoeae; adolescence (12-20); clinical research; communicable disease diagnosis; cooperative study; emergency care; epidemiology; human subject; sexually transmitted diseases; urinalysis

Adolescents who have received care in Emergency Departments represent a group who do not regularly seek health care from facilities providing preventative reproductive health screening yet who have a high prevalence of asymptomatic and a unrecognized STDS. In this project urine LCR screening for Neisseria gonorrhoeae and Chlamydia trachomatis provided through outreach (as opposed to clinic-based) activity and guided by a social network informed screening protocols originating with infected individuals identified at the time of emergency room attendance will be studied. The specific aims of this project are: 1) To define the prevalence of undetected N. gonorrhoeae and C. trachomatis in adolescents receiving care for reasons other than possible STD-related complaints at a large urban emergency room; 2) To characterize in an exploratory fashion, the health seeking behaviors, social (and sexual) networks, and other epidemiologic and behavioral characteristics of adolescents with and at risk for STDs attending the emergency room; 3) To conduct a randomized clinical trial comparing traditional health department partner notification activities to a social network-informed screening intervention for identifying and testing bacterial STDs using LCR tests; 4) To d4evelop, in partnership with our local health department, new strategies for identifying and treating STDs in a high prevalence community as well as opportunities for preventing future infection in adolescents identified through opportunistic screening performed at the time of emergency room attendance. Outcome measures will include descriptive analyses of reproductive health care seeking behaviors in adolescents seen in the emergency room, the prevalence of otherwise undetected bacterial STDs in adolescents seen in emergency room, and the numbers of infected persons identified through netowrk- informed outreach and screening per unit of Health Department Disease Int4rvention Activity time. The project has the potential to provide one of the most randomized clinical trials for evaluating traditional partner notification activities as compared to other outreach mechanisms for identifying individuals with and at risk for STDs, as well as providing a new strategy for STD intervention in adolescents, the group with highest STD morbidity.

在急诊科接受治疗的青少年代表了一个群体，他们不定期向提供预防性生殖健康检查的机构寻求保健，但他们的无症状性传播疾病和未被发现的性传播疾病的患病率很高。在本项目中，将研究通过外展活动（而不是以诊所为基础）提供的淋病奈瑟菌和沙眼衣原体尿液LCR筛查，并在社会网络的指导下，在急诊室就诊时确定由感染者发起的知情筛查方案。该项目的具体目标是：1)确定在大型城市急诊室接受治疗的青少年中未被发现的淋病奈瑟菌和沙眼奈瑟菌的患病率，而不是因为可能与性传播疾病有关的投诉；2)以探索性的方式描述急诊科有性病风险的青少年的求医行为、社会（和性）网络以及其他流行病学和行为特征；3)开展一项随机临床试验，比较传统的卫生部门伴侣通知活动与使用LCR检测识别和检测细菌性性传播疾病的社交网络知情筛查干预；4)与我们当地的卫生部门合作，制定在高流行社区识别和治疗性传播疾病的新战略，以及通过在急诊室就诊时进行机会性筛查来预防青少年未来感染的机会。结果测量将包括对在急诊室就诊的青少年寻求生殖保健行为的描述性分析，在急诊室就诊的青少年中未被发现的细菌性性传播疾病的患病率，以及通过网络知情外展和卫生部门疾病预防活动时间单位筛查确定的感染者人数。该项目有可能提供最随机的临床试验之一，以评估传统的伴侣通知活动与其他外展机制相比，用于识别患有性传播疾病和面临性传播疾病风险的个体，并为性病发病率最高的青少年群体提供性病干预的新策略。