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Comparative Study
. 2010 May 20:11:39.
doi: 10.1186/1471-2296-11-39.

Trends in sexually transmitted infections in the Netherlands, combining surveillance data from general practices and sexually transmitted infection centers

Ingrid V F van den Broek  1 , Robert A Verheij, Christel E van Dijk, Femke D H Koedijk, Marianne A B van der Sande, Jan E A M van Bergen
Affiliations
Comparative Study

Trends in sexually transmitted infections in the Netherlands, combining surveillance data from general practices and sexually transmitted infection centers

Ingrid V F van den Broek et al. BMC Fam Pract. .

Abstract

Background: Sexually transmitted infections (STI) care in the Netherlands is primarily provided by general practitioners (GPs) and specialized STI centers. STI surveillance is based on data from STI centers, which show increasing numbers of clients. Data from a GP morbidity surveillance network were used to investigate the distribution in the provision of STI care and the usefulness of GP data in surveillance.

Methods: Data on STI-related episodes and STI diagnoses based on ICPC codes and, for chlamydia, prescriptions, were obtained from GP electronic medical records (EMRs) of the GP network and compared to data from STI centers from 2002 to 2007. Incidence rates were estimated for the total population in the Netherlands.

Results: The incidence of STI-consultations and -diagnoses increased substantially in recent years, both at GPs and STI centers. The increase in consultations was larger than the increase in diagnoses; Chlamydia incidence rose especially at STI centers. GPs were responsible for 70% of STI-related episodes and 80-85% of STI diagnoses. STI centers attract relatively younger and more often male STI-patients than GPs. Symptomatic STIs like Herpes genitalis and genital warts were more frequently diagnosed at GPs and chlamydia, gonorrhea and syphilis at STI centers.

Conclusions: GPs fulfill an important role in STI care, complementary to STI centers. Case definitions of STI could be improved, particularly by including laboratory results in EMRs. The contribution of primary care is often overlooked in STI health care. Including estimates from GP EMRs can improve the surveillance of STIs.

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Figures

Figure 1
Figure 1
Annual number of STI episodes at GPs (divided in STI-related episodes, i.e. fear of STI/HIV, and episodes with STI/HIV diagnoses) and consultations at STI centers, divided in negative consultations (without diagnosis) and positive STI/HIV diagnoses, LINH-DB and SOAP surveillance, the Netherlands, 2002-2007.
Figure 2
Figure 2
Trends in STI-diagnoses registered by GPs (A) and STI centers (B) in the Netherlands, 2002-2007. Estimates from GP surveillance (LINH-DB) extrapolated of 60 sentinel surgeries and numbers from national surveillance of 32 STI centers (SOAP).
Figure 3
Figure 3
Incidence of STIs in male and female patients seen at GPs (LINH-DB 2006) and at STI centers (SOAP 2007). Bars indicate 95% confidence intervals.
See this image and copyright information in PMC

References

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