Pilot study to introduce a notification card for partner notification of sexually transmitted infections in Catalonia, Spain, June 2010 to June 2011

We conducted a cross-sectional study in 10 primary care centres in Catalonia, to determine applicability, acceptability and effectiveness of partner notification cards used by patients diagnosed of a sexually transmitted infection (STI) and to characterise these and their sexual partners. Statutorily notifiable STIs included Chlamydia infection, gonorrhoea, syphilis, human immunodeficiency virus (HIV) infection or other STIs as deemed necessary by the treating physician. Between June 2010 and June 2011, 219 index cases were enrolled, of whom 130 were men (59.4%), 71 of them men who have sex with men (54.6%). Chlamydia infection (41.1%), gonorrhoea (17.8%) and syphilis (16.0%) were the STIs most frequently diagnosed. HIV infection accounted for 4% of cases. A total of 687 sexual partners were reported, and 300 of these were traceable through the notification card (45.7%). Those who did not report traceable contacts were older (mean age: 34 years versus 31 years, p=0.03). The main reason for not distributing the card was anonymous sexual intercourse (38%). Patient referral notification cards can reach a high percentage of sexual partners at risk. However, only few notified sexual partners attended participating health centres. Internet-based partner notification may be considered in order to reach those partners not otherwise traceable

Utilidad de la exploración física para el diagnóstico de neumonía infantil adquirida en la comunidad en un centro de atención primaria

Objetivo. Determinar la utilidad diagnóstica de tres signos clínicos (fiebre, tos, estertores crepitantes) para el diagnóstico de neumonía en niños; evaluar la concordancia en la interpretación de la radiografía de tórax por dos radiólogos. Diseño. Estudio de pruebas diagnósticas. Emplazamiento. Atención primaria. Material. Trescientas cincuenta historias clínicas de niños a los que se practicó una radiografía de tórax urgente para diagnosticar neumonía entre el 1 de enero de 1996 y el 30 de junio de 1999. Mediciones principales. a) Prevalencia de neumonía en toda la muestra y en dos subgrupos de edad: igual o inferior a 5 años y superior a 5 años; b) cocientes de probabilidad positivo y negativo e intervalos de confianza del 95% (IC del 95%). Se consideró la radiografía de tórax como estándar de referencia, y c) concordancia interradiólogos-índice kappa (*). Resultados. La prevalencia de neumonía en toda la muestra fue del 22,9% (IC del 95%, 18,5-27,3); en los niños de 5 años de edad o menores fue del 20,4% (IC del 95%, 15,6-25,2), y en los mayores de 5 años, del 31,3% (IC del 95%, 21,1-41,4). Los signos estudiados sólo tuvieron alguna utilidad para confirmar el diagnóstico en mayores de 5 años: el cociente de probabilidad positivo fue de 3,52 (IC del 95%, 1,28-9,69) y los radiólogos coincidieron en el diagnóstico en el 93,1% de las radiografías de tórax (* = 0,8; IC del 95%, 0,77-0,83). Conclusiones. En este estudio no se constató la presencia de un subconjunto de signos clínicos que aseguren de forma inequívoca el diagnóstico de neumonía en niños

Pilot study to introduce a notification card for partner notification of sexually transmitted infections in Catalonia, Spain, June 2010 to June 2011

We conducted a cross-sectional study in 10 primary care centres in Catalonia, to determine applicability, acceptability and effectiveness of partner notification cards used by patients diagnosed of a sexually transmitted infection (STI) and to characterise these and their sexual partners. Statutorily notifiable STIs included Chlamydia infection, gonorrhoea, syphilis, human immunodeficiency virus (HIV) infection or other STIs as deemed necessary by the treating physician. Between June 2010 and June 2011, 219 index cases were enrolled, of whom 130 were men (59.4%), 71 of them men who have sex with men (54.6%). Chlamydia infection (41.1%), gonorrhoea (17.8%) and syphilis (16.0%) were the STIs most frequently diagnosed. HIV infection accounted for 4% of cases. A total of 687 sexual partners were reported, and 300 of these were traceable through the notification card (45.7%). Those who did not report traceable contacts were older (mean age: 34 years versus 31 years, p=0.03). The main reason for not distributing the card was anonymous sexual intercourse (38%). Patient referral notification cards can reach a high percentage of sexual partners at risk. However, only few notified sexual partners attended participating health centres. Internet-based partner notification may be considered in order to reach those partners not otherwise traceable