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Biomedical subjects

K W Radcliffe

Publications and source records attributed to K W Radcliffe.

At least 19 recordsLinked to original sources
PubMed2006

Patient preferences for partner notification.

OBJECTIVE: To identify patient preferences for notification of sexual contacts when a sexually transmitted infection (STI) is diagnosed. METHODS: A questionnaire survey of 2544 patients attending three large genitourinary clinics at Derby, Birmingham, and Coventry in the United Kingdom. RESULTS: The median age of the respondents was 24 with 1474 (57.9%) women, 1835 (72.1%) white, 1826 (71.8%) single. The most favoured method of partner notification was patient referral, which was rated a "good" method by 65.8% when they had to be contacted because a sexual partner has an STI. Notifying contacts by letter as a method of provider partner notification is more acceptable than phoning, text messaging, or email. Respondents with access to mobile telephones, private emails, and private letters were more likely to rate a method of partner notification using that mode of communication as "good" compared to those without. With provider referral methods of partner notification respondents preferred to receive a letter, email, or text message asking them to contact the clinic rather than a letter, email or text message informing them that they may have an STI. CONCLUSION: Most respondents think that being informed directly by a partner is the best method of being notified of the risk of an STI. Some of the newer methods may not be acceptable to all but a significant minority of respondents prefer these methods of partner notification. The wording of letters, emails, or text messages when used for partner notification has an influence on the acceptability of the method and may influence success of the partner notification method. Services should be flexible enough to utilise the patients' preferred method of partner notification.

Adolescent↗
PubMed2006

Why do those using illicit drugs have higher rates of sexually transmitted infection?

The study was designed to assess the association between drug use and gonorrhoea in a UK setting and determine whether any differences identified could be explained by variations in sexual behaviour. A case control analysis was undertaken in a population of men and women presenting to an inner city sexually transmitted diseases clinic. The results were analysed using a multivariate model incorporating demographic and behavioural factors potentially associated with acquiring gonorrhoea. Infection with gonorrhoea was found to be associated with illicit drug use (odds ratio 1.8, 1.2-2.8) and the association became non-significant after controlling for sexual behaviour factors. Moderate alcohol use (<5 units/week) was associated with acquiring gonorrhoea but heavier use was not. Patients who used illicit drugs had more casual partners and more foreign partners than those with no history of drug use, but an increased numbers of foreign partners were not associated with a higher prevalence of gonorrhoea. It was concluded that drug use is associated with gonorrhoea in a UK setting. Specific sexual behaviours reported by drug users may increase their risk of gonorrhoea and provide potential targets for behavioural interventions.

Adolescent↗
PubMed2006

An unexpected case of panuveitis.

We report a case of sight-threatening secondary syphilis with HIV co-infection where atypical pattern of skin manifestations resulted in a delay in making the correct diagnosis. However, despite marked visual loss by the time correct diagnosis was made, the patient responded well, albeit slowly, to a course of intravenous benzyl penicillin.

Adult↗
PubMed2006

Comparison of outcomes of management of gonorrhoea by clinic-based test of cure with those by telephone follow-up.

We compared the outcomes in 278 patients managed with clinic-based test of cure (phase 1) for gonorrhoea with 271 patients managed with the new policy of telephone follow-up (phase 2). Almost 98% of the patients in both phases were treated within 28 days of diagnosis. Follow-up of the patients was significantly better with telephone follow-up (phase 2), with an increase in proportion of patients reviewed (76.1% compared with 59.7% in phase 1, P < 0.001). Yield of partner notification was 0.22 and 0.31 contacts per case of gonorrhoea within four weeks of treatment of the index case in phases 1 and 2, respectively.

Adult↗
PubMed2005

Reducing the risk of sexually transmitted infections in genitourinary medicine clinic patients: a systematic review and meta-analysis of behavioural interventions.

OBJECTIVES: Are behavioural interventions effective in reducing the rate of sexually transmitted infections (STIs) among genitourinary medicine (GUM) clinic patients? DESIGN: Systematic review and meta-analysis of published articles. DATA SOURCES: Medline, CINAHL, Embase, PsychINFO, Applied Social Sciences Index and Abstracts, Cochrane Library Controlled Clinical Trials Register, National Research Register (1966 to January 2004). REVIEW METHODS: Randomised controlled trials of behavioural interventions in sexual health clinic patients were included if they reported change to STI rates or self reported sexual behaviour. Trial quality was assessed using the Jadad score and results pooled using random effects meta-analyses where outcomes were consistent across studies. RESULTS: 14 trials were included; 12 based in the United States. Experimental interventions were heterogeneous and most control interventions were more structured than typical UK care. Eight trials reported data on laboratory confirmed infections, of which four observed a greater reduction in their intervention groups (in two cases this result was statistically significant, p < 0.05). Seven trials reported consistent condom use, of which six observed a greater increase among their intervention subjects. Results for other measures of sexual behaviour were inconsistent. Success in reducing STIs was related to trial quality, use of social cognition models, and formative research in the target population. However, effectiveness was not related to intervention format or length. CONCLUSIONS: While results were heterogeneous, several trials observed reductions in STI rates. The most effective interventions were developed through extensive formative research. These findings should encourage further research in the United Kingdom where new approaches to preventing STIs are urgently required.

Adult↗
PubMed2001

Demographic and behavioural profile of adults infected with chlamydia: a case-control study.

OBJECTIVES: To determine which demographic and behavioural parameters are independently associated with chlamydial infection in adults. METHODS: Subjects were recruited prospectively from male and female attendees at a large clinic for sexually transmitted infections (STI). All subjects were tested for chlamydia and gonorrhoea and asked to complete a questionnaire addressing demography, sexual and non-sexual (including drug taking) behaviour, and history of STI. Cases were those attending with a new clinical episode and found to be infected with chlamydia, but who did not have gonorrhoea. A control group was selected randomly from those found to be negative on screening for both infections. RESULTS: 986 cases and 1212 controls were recruited over one calendar year. The following were found to be independent risk factors for chlamydial infection on multivariate analysis (odds ratios with 95% confidence intervals in parentheses): being unmarried (1.8; 1.1-3.1); black Caribbean ethnicity (2; 1.5-2.7). Increasing age, fewer partners, and higher reported use of condoms were associated with a lower risk of infection. CONCLUSION: Black Caribbeans are at increased risk from chlamydia after controlling for sexual behaviour and socioeconomic status. Future research should seek an explanation elsewhere-for example, in terms of differences in sexual mixing or effectiveness of healthcare interventions.

Adolescent↗
PubMed1999

Do the factors associated with successful contact tracing of patients with gonorrhoea and Chlamydia differ?

OBJECTIVE: To assess and compare factors which may be associated with successful contact tracing in patients with gonorrhoea and chlamydia. STUDY DESIGN: Prospective observational study of patients attending a genitourinary medicine clinic with a diagnosis of gonorrhoea or chlamydia. Multivariate analysis model including demographic, socioeconomic, and behavioural variables. RESULTS: The attendance of at least one sexual contact was associated with naming more contacts for patients with gonorrhoea (OR 1.44, 95% CI 1.04-2.01). A history of gonorrhoea was associated with successful contact tracing for patients with chlamydia (OR 1.46, 95% CI 1.12-1.9). Successful contact tracing, as defined by at least one confirmed contact attendance after the index case, was not associated with age, sex, sexual orientation, history of chlamydia, use of condoms, marital status, ethnicity, or socioeconomic status for either gonorrhoea or chlamydia. CONCLUSIONS: Differences in the composition of the core groups infected with gonorrhoea and chlamydia are not explained by differences in contact tracing success. In the clinic setting studied, the outcome of contact tracing was not associated with a variety of demographic, socioeconomic, and behaviour factors.

Adult↗
PubMed1998

How well is pelvic inflammatory disease managed in general practice? A postal questionnaire survey.

OBJECTIVE: Many patients with pelvic inflammatory disease (PID) present to their general practitioners. Chlamydia trachomatis is the organism most commonly implicated in this condition. This study aims to examine how well PID is managed in the primary care setting and highlight areas for improvement. METHODS: The study was performed by sending postal questionnaires to 180 randomly selected general practitioners in Birmingham. Given the example of a woman presenting clinically with PID, the doctors were asked questions on diagnosis and treatment. To assess factors that may influence the answers, they were also asked about their sex, year of qualification, and postgraduate training. RESULTS: 139 questionnaires (77%) were returned. 91.4% of the respondents feel confident in managing patients with PID, and only 9.3% would usually refer these patients on. However, 54.7% do not perform an endocervical swab for C trachomatis, 37.4% do not include anti-chlamydial antibiotics in their treatment regimen, and 24.5% do not advise sexual partners to be screened. Female doctors, those with higher degrees, or obstetrics and gynaecology experience were more likely to give anti-chlamydial therapy, but no factors of the respondents significantly influenced contact tracing behaviour. CONCLUSIONS: The management of a patient presenting with PID should include investigation for C trachomatis and treatment with an appropriate antibiotic. As PID is often a sexually transmitted disease, contact tracing of sexual partners should be undertaken. The study suggests that a significant proportion of general practitioners would not have offered optimal management to patients with PID.

Chlamydia Infections↗
PubMed1998

Liaison between gynaecologists, microbiologists and genitourinary medicine clinics in the management of patients with genital chlamydia and gonococcal infections.

Inadequate treatment and follow-up of women with genital infection with Chlamydia trachomatis and Neisseria gonorrhoeae can cause long-term morbidity. Inadequate contact tracing can predispose to re-infection. As some women with genital infections present to agencies other than genitourinary medicine (GUM) clinics, improved liaison between these and GUM departments are important in safeguarding proper follow-up and contact tracing.

Adolescent↗