Vol. 141 No. 0304 (2011)
Clinical settings and specialities notifying cases of bacterial sexually transmitted infections in Switzerland
QUESTIONS UNDER STUDY: In the next Swiss National HIV and Sexually Transmitted Infection (STI) Strategy 2011–2017, STI control will be integrated with HIV prevention. Information is needed which will improve the targeting of professional education. The objective of this study was to describe the clinical specialities and settings to which patients with bacterial STI present in Switzerland.
METHODS: We analysed notifications of chlamydia from 01.08.2008–30.11.2008, and of gonorrhoea and syphilis from 01.07.2007–30.11.2008. We recorded patient details, the speciality of the notifying physician and the setting (primary or secondary care).
RESULTS: We included 2150 notifications of chlamydia, 1360 of gonorrhoea and 935 of syphilis. In 12.5% of notifications (556/4445) a speciality or setting could not be assigned. Most chlamydia (1282/2150, 59.6%) and gonorrhoea (902/1360, 66.3%) notifications were from primary care. Slightly more syphilis notifications (429/935, 45.9%) were from secondary than from primary care. General practitioners (GPs) were the single largest group of specialists notifying gonorrhoea (609/1360, 44.8%) and syphilis (223/935, 23.9%) and the second largest speciality notifying chlamydia (446/2150, 20.7%) after gynaecologists in primary care (702/2150, 32.7%). Where male sexual orientation was recorded, 52.5% (180/343) of gonorrhoea cases and 30.3% of syphilis cases in men who have sex with men (50/165) were notified by GPs.
CONCLUSIONS: GPs and other specialists in primary care notify the majority of chlamydia and gonorrhoea and a substantial percentage of syphilis in Switzerland. These physicians will be at the forefront of STI management and secondary prevention to be delivered as part of an integrated HIV and STI strategy.
- Bundesamt für Gesundheit. Sexuell übertragbare Infektionen (STI) in der Schweiz 1988 bis 2006. Bulletin Bundesamt für Gesundheit 2008;(8):140–9.
- Swiss Federal Office of Public Health. Reports of infectious diseases. http://www.bag.admin.ch/infreporting/gs02/e/index.htm. Bern: Bundesamt für Gesundheit; 2010.
- Holmes KK, Sparling PF, Stamm WE, et al. Sexually Transmitted Diseases. 4th Edition ed. New York: McGraw-Hill, 2008.
- Lautenschlager S. Sexually transmitted infections in Switzerland: return of the classics. Dermatology. 2005;210(2):134–42.
- Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect. 1999;75(1):3–17.
- Szöllösy G, Gnädinger M. Nationales HIV & STI Programm 2011–2015: Auswertung des Stakeholder-Inputs. Bern: Bundesamt für Gesundheit; 2010.
- Kessler C, Swiss Centre for International Health. International Context Analysis. HIV & STI Programmes: The European and International Reference. Bern: Bundesamt für Gesundheit; 2009.
- Zwahlen M, Spoerri A, Gebhardt M, Mausezahl M, Boubaker K, Low N. Surveillance Systems for Sexually Transmitted Diseases in Switzerland. Sex Transm Dis. 2007;34(2):76–80.
- Paget WJ, Zimmermann HP. Surveillance of sexually transmitted diseases in Switzerland, 1973–1994: evidence of declining trends in gonorrhoea and syphilis. Soz Präventivmed. 1997;42(1):30–6.
- Van Bergen JE, Kerssens JJ, Schellevis FG, Sandfort TG, Coenen TJ, Bindels PJ. Prevalence of STI related consultations in general practice: results from the second Dutch National Survey of General Practice. Br J Gen Pract. 2006;56(523):104–9.
- Brackbill RM, Sternberg MR, Fishbein M. Where do people go for treatment of sexually transmitted diseases? Fam Plan Perspect. 1999;31(1):10–5.
- Datta SD, Sternberg M, Johnson RE, et al. Gonorrhea and Chlamydia in the United States among Persons 14 to 39 Years of Age, 1999 to 2002. Ann Intern Med. 2007;147(2):89–96.
- Fenton KA, Korovessis C, Johnson AM, et al. Sexual behaviour in Britain: reported sexually transmitted infections and prevalent genital Chlamydia trachomatis infection. Lancet. 2001;358:1851–4.
- The UK Collaborative Group for HIV and STI Surveillance. Testing Times. HIV and other Sexually Transmitted Infections in the United Kingdom: 2007. London: Health Protection Agency Centre for Infections; 2007 Nov.
- Low N, Cassell JA, Spencer B, et al. Screening for Chlamydia Review in Europe, project SCREen: final report. http://ecdc.europa.eu/pdf/chlamydia_control.pdf. European Centre for Disease Prevention and Control; 2008.
- Paget WJ, Zbinden R, Ritzler E, et al. National laboratory reports of Chlamydia trachomatis seriously underestimate the frequency of genital chlamydial infections among women in Switzerland. Sex Transm Dis. 2002;29(11):715–20.