Timeliness of Treatment for Gonorrhea: Are Venue-Based Performance Measures (PM) Enough?

Background: Early detection and prompt treatment are core strategies for many public health programs.  STD programs have reported timeliness of treatment on gonorrhea cases in prevalence monitoring family planning clinics (PMFP) since 2005 and STD clinics since 2007. Programs assure appropriate treatment within 14 days for 64% of women in PMFP sites and 72% of women in STD clinics

Objectives: Assess potential impact of measuring of timeliness of treatment for all cases.

Methods: The number of women testing positive in PMFP and STD clinics was compared with total gonorrhea morbidity. The number of cases who received appropriate treatment within 14 days of specimen collection were also compared with total reported gonorrhea morbidity. 

Results: The percentage of women testing positive for gonorrhea from PMFP clinics and STD clinics when compared to total morbidity was 5.3% and 7.8%, respectively. The percentage of women testing positive for gonorrhea and treated within 14 days from PMFP clinics and STD clinics was 3.4% and 5.6% of total morbidity respectively.

Conclusions: STD prevention efforts should reduce total morbidity and PMs should reflect this focus.  Assuring treatment of only women who test positive in these settings is insufficient to impact overall gonorrhea morbidity and distracts from the broader goals of reducing morbidity. The division of STD prevention should consider monitoring timeliness of treatment for all gonorrhea regardless of venue, gender, or age

Implications for Programs, Policy, and/or Research: Monitoring timely treatment of all gonorrhea is an important component of a gonorrhea prevention plan.  Capturing these data will require additional efforts from severely strained health departments; however this more appropriate focus should allow for detection and corrective actions to address care providers who don’t treat their patients promptly.