Sexually transmitted diseases in patients attending a Baltimore tuberculosis clinic. Assessment of use of multiple categoric services

Abstract

Background: Recent increases in the incidence of tuberculosis and syphilis have occurred disproportionately in young heterosexuals of low socioeconomic status. The authors hypothesized that an overlap of tuberculosis and sexually transmitted disease clinic populations potentially could result in inefficient use of limited public health resources.

Methods: The authors conducted a retrospective study to determine the coinfection rate of syphilis and other sexually transmitted diseases in patients seen for evaluation at the Baltimore City Tuberculosis Clinic, Baltimore, Maryland. The authors determined the sexually transmitted disease clinic utilization patterns of this patient population.

Results: For patients referred to the tuberculosis clinic, 9.0% had a history of syphilis and 13.6% had at least one documented visit at a Baltimore City sexually transmitted disease clinic. Blacks presenting to the tuberculosis clinic were more likely to have previously diagnosed syphilis (13.6%) and to have had visited the sexually transmitted disease clinics (16.5%).

Conclusions: In Baltimore, the patient population of tuberculosis clinics overlaps with those at the public sexually transmitted disease clinics. Thus, cross screening for syphilis and tuberculosis at urban clinics would be an important mechanism for identifying new cases of disease and increasing the efficiency of the public health system.