ArticleBMJ open2019
Regional differences in chlamydia and gonorrhoeae positivity rate among heterosexual STI clinic visitors in the Netherlands: contribution of client and regional characteristics as assessed by cross-sectional surveillance data.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Identification of risk profiles among persons attending a sexually transmitted infection clinic in Estonia.PloS one · 2026Article
- Estimated effect of reduced asymptomatic testing on missedThe Lancet regional health. Europe · 2025Article
- Sexual behavioral factors of the subjects visiting the clinic of sexually transmitted infections in Northern Finland: A cross-sectional study among 775 subjects.Health science reports · 2023Article
- An Automated Surveillance System (SurCeGGID) for the French Sexually Transmitted Infection Clinics: Epidemiological Monitoring Study.JMIR formative research · 2022Article
- Introducing video consultations at public sexual health clinics in the Netherlands: a mixed-methods study.Health promotion international · 2022Article
- Impact of the SARS-COV-2 Pandemic Lockdown on Sexually Transmitted Urethritis in a Spanish Health Region.Cureus · 2021Article
- The characteristics of patients frequently tested and repeatedly infected with Chlamydia trachomatis in Southwest Limburg, the Netherlands.BMC public health · 2020Article
- The Characteristics of Patients Frequently Tested and Repeatedly Infected withInternational journal of environmental research and public health · 2020Article
- Estimating nationwide cases of sexually transmitted diseases in 2015 from sentinel surveillance data in Japan.BMC infectious diseases · 2020Article
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Authors and funding
4 authors.
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Abstract
objectivesTo assess to what extent triage criteria, client and regional characteristics explain regional differences in
designRetrospective cross-sectional study on the Dutch STI surveillance database of all 24 STI clinics.
participantsSTI clinic visits of heterosexual persons in 2015 with a Ct (n=101 495) and/or Ng test (n=101 081). PRIMARY OUTCOME MEASURE: Ct and Ng positivity and 95% CI was assessed for each STI clinic. Two-level logistic regression analyses were performed to calculate the percentage change in regional variance (PCV) after adding triage criteria (model 1), other client characteristics (model 2) and regional characteristics (model 3) to the empty model. The contribution of single characteristics was determined after removing them from model 3.
resultsCt positivity was 14.9% and ranged from 12.6% to 20.0% regionally. Ng positivity was 1.7% and ranged from 0.8% to 3.8% regionally. For Ct, the PCV was 11.7% in model 1, 32.2% in model 2% and 59.3% in model 3. Age, notified for Ct (triage), level of education (other characteristics) and regional degree of urbanisation (region) explained variance most. For Ng, the PCV was 38.7% in model 1, 61.2% in model 2% and 69.1% in model 3. Ethnicity (triage), partner in risk group, level of education and neighbourhood (other characteristics) and regional socioeconomic status (SES) explained variance most. A significant part of regional variance remained unexplained.
conclusionsRegional variance was explained by differences in client characteristics, indicating that triage and self-selection influence positivity rates in the surveillance data.Clustering of Ng in low SES regions additionally explained regional variance in Ng; targeted interventions in low SES regions may assist Ng control. Including educational level as triage criterion is recommended. Studies incorporating prevalence data are needed to assess whether regional clustering underlies unexplained regional variance.
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