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Biomedical subjects

J J Potterat

Publications and source records attributed to J J Potterat.

16 recordsLinked to original sources
PubMed1990

Epidemiologic differences between chlamydia and gonorrhea.

To assess the prevalence, demographics, and transmission patterns of genital chlamydia infection, we screened 3,078 patients, and compared identified cases (N = 511) to gonorrhea cases (N = 291) diagnosed in the same setting. Chlamydia cases were younger and more likely to be White than their gonorrhea counterparts. Chlamydia cases were distributed diffusely; geographic overlap between the two diseases was only about 40 percent. Gonococcal coinfection was noted in less than 10 percent of patients with chlamydia. Nearly half of men with chlamydia and four-fifths of women were asymptomatic and most cases were identified through screening or contact tracing. Populations at high risk for chlamydia are seemingly different from those for gonorrhea. Differences may be due to control interventions (active for gonorrhea, passive for chlamydia). Chlamydia case reporting and control initiatives are recommended.

Age Factors↗
PubMed1989

Partner notification in the control of human immunodeficiency virus infection.

Partner notification should be standard public health practice in the control of human immunodeficiency virus (HIV) infection. A universal partner notification program for the United States is affordable, operationally manageable, and can effectively reach high-risk persons. Such a focused approach personalizes the epidemic and probably enhances the efficacy of risk reduction messages. Confidentiality protections are attainable. Voluntary partner notification is acceptable to our constituents; while counseling is "mandatory," testing is optional. Evidence of partner notification's usefulness as a case prevention tool should be a by-product of program outcomes and not a prerequisite for its implementation.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Prepubertal infections with Neisseria gonorrhoeae: clinical and epidemiologic significance.

The family constellations and epidemiologic circumstances of three prepubertal girls with vulvovaginitis due to Neisseria gonorrhoeae are reported. In each instance, an infected asymptomatic man, himself a contact to a woman with pelvic inflammatory disease, could be implicated as the potential source of infection. In one instance, asymptomatic infection in a child was uncovered through epidemiologic investigation. Prepubertal gonococcal vaginitis is important not only as a potential indicator of child abuse, but also as a possible link to important transmitters of gonococcal infection. The need for meticulous epidemiologic investigation of these cases is stressed.

Age Factors↗
PubMedDate not supplied

Gonorrhea in street prostitutes: epidemiologic and legal implications.

Sociodemographic characteristics of a group of street prostitutes in Colorado Springs, Colorado, were determined through retrospective chart review and compared with those of a group of nonprostitute women seen at a venereal disease clinic. Initially, the risk that prostitutes would contract gonorrhea was substantially higher than the risk for other women (31% vs. 21%) but the risks for both groups decreased over the two-year period during which control measures were applied. These measures included use of legal orders, based on the constitutional requirement of "least restrictive alternative." Prostitutes in this setting may well constitute a "core group" of transmitters.

Adolescent↗
PubMedDate not supplied

Gonorrhea as a social disease.

Gonococcal infection in Colorado Springs, Colorado, is concentrated in about 1% of the population. The social groups at risk are characterized as young, nonwhite, heterosexual, and connected to the military. They exhibit residential proximity by clustering in "core" census tracts; 51% of cases were in four tracts. They demonstrate residential stability and close social association at preferred sites for nighttime leisure activity (six major sites out of 300 available). Social aggregation is further demonstrated by the length of social contact prior to sexual contact (45% had known each other for over two months), the neighborhood nature of sexual choices, and the grouping of sexually connected individuals in lots (six lots contained 20% of cases). The force of infectivity, measured in person-days of potential spread of gonorrhea by infected contacts, provides a quantitative assessment of the important of identifiable social groups in the transmission of gonorrhea.

Colorado↗
PubMedDate not supplied

Disease transmission by heterosexual men with gonorrhea: an empiric estimate.

In Colorado Springs, Colorado, between January and June 1981, approximately 400 cases of gonorrhea in heterosexual men generated approximately 200 "spread" cases in women. The ratio of spread cases to index cases (0.5) is an empiric measure of the reproductive rate for the disease, i.e., the rate at which an infected person replaces himself. Although a reproductive rate of less than one theoretically should produce extinction of the disease, the rate derived from these data is shown to be a weighted average of the rates in symptomatic men (0.31), subsymptomatic men (0.79), and asymptomatic men (1.30). Approximately 35% of gonorrhea transmitted by men may be attributed to the asymptomatic group, which constitutes 10-15% of the infected population. If the observations in this community are applied to the nation as a whole, we estimate that approximately 1.7 million cases of gonorrhea occurred in 1981, as compared with the 990,864 cases actually occurred in 1981, as compared with the 990,864 cases actually reported. This estimate is close to those usually quoted but differs in gender composition. Whereas the observed male-to-female ratio is 1.48:1, the predicted ratio, based on estimates of reproductive rates in subgroups, is 0.8. This analysis supports the theoretical notion that the endemicity of gonorrhea is maintained by heightened transmission within small groups, and it suggests that underdetection is more important than underreporting in the assessment of the "true" incidence of this infection.

Colorado↗
PubMedDate not supplied

Temporal and social aspects of gonorrhea transmission: the force of infectivity.

Theoretical consideration of the epidemiology of sexually transmitted diseases (STD) suggests that the key determinants of transmission dynamics are the duration of infectiousness and the extent to which subgroups in the population interact sexually. We used two empirical correlates to represent these concepts: (1) the force of infectivity, calculated by summing all the days of potential infectivity (the time between last sexual exposure and treatment of the contact) generated by a given case, and then summing the days for all cases within a given subgroup; (2) self-selection, representing the observed probability that members of a given subgroup select sexual partners from within their own group. Using data gathered in Colorado Springs, Colorado, we estimated that a single group i.e., black, male, heterosexual, military personnel residing in the core areas, generated 27% of the force of infectivity. Subgroups that select greater than 50% of their sexual partners from outside their sociodemographic boundaries generated a rate for the force of infectivity that was 4.5 times higher than the rate for self-selectors. These findings confirm the core group theory and suggest strategies for control of STD.

Adult↗
PubMedDate not supplied

A civilian-military partnership to reduce the incidence of gonorrhea.

To reduce the incidence of gonorrhea in the Colorado Springs, Colo., area, casefinding measures (interviewing of patients and tracing of contacts) were conscientiously applied by the local health department, in cooperation with the U.S. Army, to more than 90 percent of reported cases during a 3-year period. Nearly 4,000 cases of gonorrhea--2,127 civilian and 1,811 military--were interviewed; they named 7,399 contacts. A total of 1,141 cases of gonorrhea were newly identified and patients brought to treatment in Colorado Springs as a result. Implementation of these measures was associated with a 12.9 percent overall decline in gonorrhea incidence. This decline was most pronounced in the civilian population (20 percent), while little change in incidence occurred in the military population. The data presented suggest that the orderly application of casefinding epidemiology, allied with other control program initiatives, can interrupt transmission of, and prevent, disease.

Colorado↗