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PubMed2002

Sex difference in partner notification: results from three population based surveys in France.

OBJECTIVES: To estimate the proportion of individuals in the general population who did not notify their sexual partners at the time of an STD diagnosis, according to the sex of the patient and the type of partner. METHODS: We analysed behaviour at the time of diagnosis of a self reported STD, using data from three large French national population based surveys of adults (ACSF, Barométre Santé) and adolescents (ACSJ). Univariate and multivariate analyses took into account the complex sampling design. RESULTS: In the ACSF, 14% (95% CI: 4% to 24%) of men reported that they had not informed their main sexual partner compared with only 2% (95% CI: 0% to 5%) of women (p = 0.03). This sex difference was independent of the nature of the STD, the patient's age, level of education, and number of partners. Similarly, in the ACSJ, 51% (95% CI: 21% to 81%) of boys reported that they had not talked about this STD with their current sexual partner compared with only 9% (95% CI: 0% to 26%) of girls (p = 0.04). Notification by a sexual partner had led to discovery of the STD more frequently in male subjects than in female subjects, both in adults (32% of men compared with 4% of women (p=0.04)), and adolescents (36% of boys compared with 12% of girls). Most subjects, irrespective of sex, had not informed partners other than their main or current partner: 73% (95% CI: 62% to 84%) of adults and 86% (95% CI: 77% to 95%) of adolescents. CONCLUSIONS: Procedures must be developed urgently to improve the notification of sexual partners, particularly female partners and adolescents, who are unlikely to be tested early without such notification.

Adult↗
PubMed2002

Evaluation of a video based health education strategy to improve sexually transmitted disease partner notification in South Africa.

OBJECTIVES: To evaluate the feasibility and impact of a health education intervention promoting partner notification for sexually transmitted diseases (STDs). METHODS: The research setting was a busy public health clinic in a rural district in KwaZulu Natal, South Africa. A before/after quantitative study design was used to measure the effect of an audiovisual presentation of a compelling love drama, posters, and pamphlets. Measures collected from all consenting STD index patients during a 6 week pre-intervention (control) phase were compared with those collected during a 6 week intervention phase. A qualitative evaluation assessed whether the intervention accurately portrayed the intended educational messages. RESULTS: 150 index patients (55% female) were interviewed in the control phase and 185 index patients (64% female) in the intervention phase. The intervention phase showed improvements on several measures of self efficacy about notifying casual partners, such as a belief among index patients that a greater proportion of their casual partners would see the importance of seeking treatment as a result of their notification interaction. The rate of contact cards returned per index patient was 0.27 in the intervention phase, compared with 0.20 in the control phase (95% CI for the rate difference: -0.05, 0.17). The qualitative research found that the intervention was thoroughly enjoyed by patients and clinicians, but a fundamental problem with it was that patients received confused messages about the relation between HIV/AIDS and other STDs. This has potentially negative consequences for partner notification. CONCLUSION: The intervention needs further development, and then could provide a highly acceptable, cost effective model for health education in clinics in developing countries.

Adult↗
PubMed1992

National survey of notifications of tuberculosis in England and Wales in 1988. Medical Research Council Cardiothoracic Epidemiology Group.

BACKGROUND: A survey was undertaken to determine the distribution of tuberculosis in England and Wales and, by comparison with the findings of similar surveys in 1978-9 and 1983, to study trends in the incidence of the disease by ethnic group over the decade. METHODS: The survey included all cases of tuberculosis in England and Wales newly notified to the medical officers for environmental health during the six months from 2 January to 1 July 1988. Notification rates were calculated from population estimates from the 1988 Labour Force Survey. RESULTS: Clinical details were obtained from the clinician for 2149 (99.4%) of the 2163 newly notified and previously untreated patients. Over 90% were either white (53%) or of Indian, Pakistani, or Bangladeshi ethnic origin (39%). The notification rate in the white population was 4.7/100,000/year, a decline of 7.2% per year since 1978. The rate was 134.6/100,000/year in the population of Indian ethnic origin, and 100.5/100,000/year in that of Pakistani or Bangladeshi ethnic origin, a decline of 6% a year since 1978 for the two groups combined (standardised for age, country of birth, and length of time in the UK). In all ethnic groups rates of disease were much higher in the elderly than in the young. Bacteriological results were available in 1161 (80%) of the 1443 pulmonary cases. In 939 (81%) Mycobacterium tuberculosis was cultured; 614 cases (53%) also had positive smears, of which 424 (69%) were from white patients. CONCLUSIONS: Notification rates for tuberculosis in England and Wales declined over the decade, but major differences remained between ethnic groups.

Adolescent↗
PubMed1997

Gonorrhoea in Coventry 1991-1994: epidemiology, coinfection and evaluation of partner notification in the STD clinic.

The aim of this study is to analyse the epidemiology of gonorrhoea in the Coventry area between 1991-1994 and the implementation and outcome of partner notification. A total of 404 episodes in 382 patients comprised the study group. In Coventry, 97% of episodes were managed in the STD clinic. There was a decrease in female and heterosexual male cases from 172 cases in 1991 to 37 cases in 1994 and increase in homosexual male cases from 8 in 1991 to 13 in 1994 (P<0.0001). Chlamydial coinfection was found in 38%. Among patients with gonorrhoea, 33% were asymptomatic and 40% with gonorrhoea and chlamydia were asymptomatic. Ten per cent of index cases were asymptomatic as were 83% of contact cases (P<0.0001). The health advisers (HAs) interviewed 82% immediately and 94% at some time after diagnosis. Of the average 1.5 partners per patient identified, 0.31 partners per patient were already screened, another 0.4 partners per patient were traced, 0.37 partners per patient were not traced, and for 0.41 partners per patient notification outcome was unknown or unconfirmed. Partner notification of 278 index cases traced 163 primary or tertiary contacts, 115 were new cases of gonorrhoea.

Adolescent↗
PubMed1995

The risk of domestic violence and women with HIV infection: implications for partner notification, public policy, and the law.

Partner notification has emerged as an important strategy in the fight against acquired immunodeficiency syndrome (AIDS), and states have now adopted a plethora of laws that encourage or mandate notification, often without the patient's consent. As human immunodeficiency virus (HIV) infection continues to spread among women, the future development of AIDS control strategies and public health laws must be shaped by concern for the safety and autonomy of patients who face a risk of domestic violence. Three distinct recommendations flow from this premise. First, all HIV-infected women should be assessed for the risk of domestic violence and offered appropriate interventions. Second, where a risk of abuse is indicated, partners should never be notified without the patient's consent. State laws that presently permit involuntary notification should be repealed or amended. Third, laws that punish a patient's refusal to notify partners should also be modified or repealed.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Partner notification program and possibility of including it in the HIV prevention strategies in Japan.

This article discusses the possibility of implementing partner notification program as a part of HIV prevention strategy in Japan. Relevant factors, like HIV seroprevalence, general population attitudes toward HIV, legislation, resources, barriers, behavioral changes, cost and effectiveness are analyzed in Japanese perspectives. Effectiveness of this program is also predicted based on the two informal contact tracing program in Japan. At the same time a review was made on the global perspectives of partner notification program and operational procedures are also outlined. Published literatures were investigated regarding prevalence of new HIV infection among the partners who underwent testing (11-39%), cost per new HIV positive case found (US $810-3,205), and secondary infection rate (11-20%) in Japan. Having considered all relevant factors we recommend that the partner notification program be implemented, initially in a limited area, then all over Japan. Further analysis on cost-benefit of this program remains to be done.

Adult↗
PubMed1998

Tuberculosis notifications in Australia, 1996. Communicable Diseases Network Australia New Zealand.

Since the implementation of the National Mycobacterial Surveillance System (NMSS) in 1991, the epidemiology and trends of tuberculosis in Australia have been described in a series of annual reports. This article presents an analysis of the data for tuberculosis notifications for 1996. A total of 1,037 notifications of tuberculosis were received for the year 1996, and the crude rates of new and relapsed disease were reported at 5.37 per 100,000 and 0.29 per 100,000 respectively. Rates of tuberculosis have remained stable over the last decade and the majority of notifications and highest rates of disease continue to occur in the overseas-born population.

Adolescent↗
PubMed1993

Human immunodeficiency virus notifications for aborigines and Torres Strait Islanders in Queensland.

OBJECTIVE: To describe the epidemiology of HIV infection based on notifications of HIV infection in Aboriginal and Torres Strait Islander people in Queensland and to review their implications for Aboriginal and Torres Strait Islander communities. DESIGN: Descriptive study of data obtained through HIV notifications to the AIDS Medical Unit, Specialised Health Services, Queensland Health from 1 July 1985 to 31 August 1991. SUBJECTS: Aboriginal and Torres Strait Islander people of Queensland. MAIN OUTCOME MEASURES: Centers for Disease Control (CDC) classification of HIV infection, as at 31 August 1991. RESULTS: Twenty-nine individuals identified as Aboriginal or Torres Strait Islander were notified as positive for HIV antibodies in the period 1 July 1985 to 31 August 1991. Of those diagnosed, three were female and 26 male. At 31 August 1991, only 10 were asymptomatic (CDC Group II, III), eight were symptomatic (AIDS-related complex) and 11 were diagnosed as having AIDS. Seven of those with a diagnosis of AIDS had died by the end of the study period. By comparison, 1158 non-Aboriginal or Torres Strait Islander people were notified for the same time period. Of these, 48 were female, 1105 were male and five were transsexual. In the non-Aboriginal and Torres Strait Islander group, 633 were asymptomatic and 297 were diagnosed with AIDS. By the end of the study period, 228 had died. CONCLUSIONS: The data show an estimated prevalence of diagnosed HIV infection in Aboriginal and Torres Strait Islander people in Queensland comparable with the rest of the population. Cases are distributed throughout the State, though some clustering is evident. There has been a stable pattern of notifications over the past five years. The proportion of asymptomatic (CDC groups II, III) HIV-positive Aboriginal and Torres Strait Islander clients was significantly lower than for the non-Aboriginal and Torres Strait Islander group. These data have implications in terms of projections of total cases, diagnosed and undiagnosed, and relative access to the advantages attending early diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Program development and routine notification in a large, independent OPO: a 12-year review.

Since its inception 12 years ago, a large, independent OPO experienced a 631% growth in the number of organ donors. These increases in organ recovery were achieved initially through successful mergers, and later, following the mergers, through focused management, OPO organizational development, and hospital marketing and system development. The cumulative percentage increases beginning in 1987 resulted in the OPO achieving 27.2 donors per million population. In 1996 a system of routine notification of all hospital deaths was implemented and a 24-hour communications center was operated. After 3 full years of routine notification, 73% of all deaths were called to the OPO, resulting in the following increases: total referrals, 691%; organ referrals, 41%; organ donors, 16%; bone donors, 149%; skin donors, 123%; and heart valve donors, 78%. The 16% increase in organ donors was twice the national growth rate and significantly more than the 2% growth experienced by the OPO in the year preceding the implementation of routine notification. The OPO has demonstrated sustained growth over the past decade in a time when erosion of donor recovery levels is always a possibility and frequently a reality for many OPOs.

Humans↗
PubMed1995

Minimizing aminoglycoside toxicity by prescriber notification of prolonged therapy.

The development of aminoglycoside toxicity has been reported related to duration of exposure. To potentially reduce the duration of exposure to aminoglycosides, pharmacists documented, via a permanent note in the patient health record, the exposure and potential associated risks of any patient who received greater than 10 consecutive days or 20 days total within 3 months of aminoglycoside therapy at this institution. The impact of the notification on further aminoglycoside exposure was evaluated over two 6-month periods. Notification was successful in ending further aminoglycoside exposure in 25 of 57 patients. Continued aminoglycoside therapy primarily involved treatment of febrile neutropenia and endocarditis. Prevention of toxicity was suggested in the second evaluation period in which none of the patients, having therapy altered by the notification, developed toxicity versus 13 of the 40 other patients who developed a rise in serum creatinine concentration or a reduction in hearing acuity. The methodology that produced these positive results should be easily transferable to other institutions.

Aminoglycosides↗
PubMed1998

"Guidance for industry: current good manufacturing practice for blood and blood components: (1). Quarantine and disposition of units from prior collections from donors with repeatedly reactive screening test for antibody to hepatitis C virus (anti-HCV); (2). Supplemental testing, and the notification of consignees and blood recipients of donor test results for anti-HCV;" availability--FDA. Notice.

The Food and Drug Administration (FDA) is announcing the availability of a guidance document (dated September 1998) entitled "Guidance for Industry: Current Good Manufacturing Practice for Blood and Blood Components: (1) Quarantine and Disposition of Units From Prior Collections From Donors With Repeatedly Reactive Screening Test for Antibody to Hepatitis C Virus (Anti-HCV); (2) Supplemental Testing, and the Notification of Consignees and Blood Recipients of Donor Test Results for Anti-HCV." The guidance document provides recommendations for donor screening and supplemental testing for antibody to hepatitis C virus (HCV), notification of consignees and quarantine of prior collections from a donor who later tests repeatedly reactive for antibody to HCV, notification of recipients of blood and blood components at increased risk for transmitting HCV.

Blood Banks↗
PubMed1987

Delays in notification of infectious disease.

The delays in notifying infectious diseases can have implications on the efficiency of public health intervention, and allowance should be made when interpreting time trends. Data on notification delays of 15 diseases over 30 years in nine Health Authorities in England are presented. Measles is the most rapidly notified (a median delay of five days between onset and notification) and tuberculosis the slowest (median two months). The notification delay has varied between diseases, between Districts and also over time, and appears to have increased in recent years. The differences are attributed to the relative ratity, acuteness and difficulty of diagnosis of the disease, to administrative differences between Districts and to changes in incidence over time.

Communicable Disease Control↗
PubMed1999

Design of a clinical notification system.

We describe the requirements and design of an enterprise-wide notification system. From published descriptions of notification schemes, our own experience, and use cases provided by diverse users in our institution, we developed a set of functional requirements. The resulting design supports multiple communication channels, third party mappings (algorithms) from message to recipient and/or channel of delivery, and escalation algorithms. A requirement for multiple message formats is addressed by a document specification. We implemented this system in Java as a CORBA object. This paper describes the design and current implementation of our notification system.

Algorithms↗
PubMed2000

[A form for the notification of cases of child abuse in Spain].

AIM: To design a form to collect national data on child abuse, which could be used by the autonomous communities and which could supply valid information for the investigation, intervention and prevention of child abuse in Spain. METHODS: A Delphi study was carried out with three questionnaires in which 59 experts from 16 autonomous communities participated. Of the experts, 53 answered the second questionnaire (89.9%) and 44 the third (74.6%). Each expert indicated whether, in his/her opinion, a specific item should be incorporated in a national register of child abuse. A consensus was considered to have been reached for a particular item when agreement between the experts was equal or higher than 85%. RESULTS: The final notification form agreed on by the participants has 29 items. It contains information on the identity of the child and the child's parents and details of the composition of the family unit and of the event that caused the notification. It also contains details of the reasons for suspecting abuse and the type of child abuse. CONCLUSIONS: We present a form agreed by consensus for the notification of child abuse that, when distributed nationally, will provide valid data for the whole of Spain.

Child↗
PubMed2000

Relevance of mandates, notifications and threads in the management of continuity of care.

Availability of electronic healthcare records (EHCR) and geographical networks allows nowadays to realise a set of functionalities to support continuity of care. Actual exchange of complete clinical information, common centralised records, common decisions within an agreed protocols are not mandatory. Sub-optimal alternatives, involving easier management, are possible. In fact, the crucial challenge for continuity of care is the mutual awareness of the multiple perspectives by the actors contributing to patient's care. The various actors should timely know changes in the status of: mandates, i.e. who is involved in the care provision and thus is responsible for a "local" record. knowledge about the patient, i.e. active and inactive problems, impressions, relevant findings. provision of healthcare activities, i.e. plans, orders and performed activities. The decisions on the actual implementation depend on the healthcare context, as implemented within the information system. For example, the mechanism for notifications involves decisions on the quality and quantity of information that must be exchanged, as well as on the modalities for the exchange, regulated by individual user's profiles. Each notification could be sent as a message to a central repository, and then each authorized user could select within the repository the pertaining messages. Or a notification could be sent directly to the list of professionals involved in the care of a patient, that asked for it in their profile. Mandates may be used to regulate the access of the users to the patient's information. This approach was embedded in a European standard under development in CEN/TC251 (CONTSYS--"System of concepts to support continuity of care").

Computer Communication Networks↗
PubMedDate not supplied

Partner notification and patient education for cases of Chlamydia trachomatis infection in a rural Nova Scotia health unit.

From September 1990 to March 1991, 47 of 52 patients with genital C. trachomatis infections in a rural health unit in Nova Scotia were interviewed about preventive education by physicians partner notification, past history, and treatment. Seventy-six percent of those with partners of the previous month were instructed by physicians to notify these partners. Twenty-five of 37 partners were notified. Of those not notified, 83% could have been reached. Reasons for cases not notifying partners included not being informed of test results, embarrassment, and not considering notification important. Fifty-two percent of cases were advised to practise safer sex; this was generally limited to advice to use condoms. Twenty-three percent had had a previous sexually transmitted disease. Treatment was appropriate in all cases where it could be determined. More preventive education by physicians and public health involvement in partner notification for such patients are required.

Adult↗
PubMed1990

Partner acceptance of health department notification of HIV exposure, South Carolina.

To determine the acceptability of health department notification of sex and needle-sharing partners of persons infected with human immunodeficiency virus (HIV), we administered an anonymous questionnaire to partners notified of their exposure to HIV during the previous 2 years. Of the 202 partners notified, 132 (65%) were locatable and completed the questionnaire. Only 12 (9%) thought they may have been exposed to HIV before health department notification. When the 132 partners were asked if they thought the health department did the right thing in telling them about their exposure, 87% responded "yes;" when asked if the health department should keep notifying persons exposed to HIV, 92% responded "yes." Responses were similar for homosexual-bisexual men, heterosexuals, and intravenous drug users; men and women; and whites and blacks. We conclude that health department notification is acceptable to persons exposed to HIV in this rural South Carolina district.

Adolescent↗