Pediatric Emergency Provider Sexually Transmitted Infection Screening Practices in Adolescents With Oropharyngeal or Anorectal Chief Complaints
| Autor: | Frances S. Shofer, Cynthia J. Mollen, Nadia Dowshen, Monika K. Goyal, Susan S. Lee, Courtney L. Gallagher |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Population Gonorrhea Sexually Transmitted Diseases Psychological intervention urologic and male genital diseases Logistic regression Article Diagnosis Differential 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Humans Mass Screening 030212 general & internal medicine education Retrospective Studies education.field_of_study business.industry Retrospective cohort study Pharyngeal Diseases General Medicine Odds ratio Chlamydia Infections Pennsylvania medicine.disease Confidence interval Rectal Diseases Pediatrics Perinatology and Child Health Emergency Medicine Female Differential diagnosis Emergency Service Hospital business |
| Zdroj: | Pediatr Emerg Care |
| ISSN: | 0749-5161 |
| DOI: | 10.1097/pec.0000000000001414 |
| Popis: | Objectives Sexually transmitted infections (STIs) may present with oropharyngeal or anorectal symptoms. Little is known about the evaluation of adolescents with these complaints in the pediatric emergency department (PED). This study aimed to determine the frequency of and factors associated with STI consideration and testing in this population. Methods Retrospective chart review of patients aged 13 to 18 years who presented to an urban PED with oropharyngeal or anorectal chief complaints between June 2014 and May 2015. Sexually transmitted infection consideration was defined as sexual history documentation, documentation of STI in differential diagnosis, and/or diagnostic testing. Multivariate logistic regression models were used to identify factors associated with consideration. Results Of 767 visits for oropharyngeal (89.4%), anorectal (10.4%), or both complaints, 153 (19.9%) had STI consideration. Of the 35 visits (4.6%) that included gonorrhea and/or chlamydia testing, 12 (34.3%) included testing at the anatomic site of complaint. Of those 12 tests, 50.0% were the incorrect test. Patients with older age (adjusted odds ratio [aOR] = 1.5, 95% confidence interval [CI] = 1.3-1.7), female sex (aOR = 1.6, 95% CI = 1.03-2.5), or anorectal complaints (aOR = 2.4, 95% CI = 1.3-4.3) were more likely to have STI consideration. Conclusions In an urban PED, only 20% of visits for adolescents with oropharyngeal or anorectal symptoms included STI consideration. Testing was performed in only 5% of cases and often at an inappropriate anatomic site or with the incorrect test. Interventions to increase awareness of appropriate STI consideration and testing for individuals presenting with possible extragenital complaints may help reduce STIs among adolescents. |
| Databáze: | OpenAIRE |
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