TY  - JOUR
VL  - 334
IS  - 7589
ID  - discovery2491
TI  - Improved effectiveness of partner notification for patients
with sexually transmitted infections: systematic review
A1  - Trelle, S.
A1  - Shang, A.
A1  - Nartey, L.
A1  - Cassell, J.A.
A1  - Low, N.
SN  - 1468-5833
Y1  - 2007/02/17/
AV  - public
JF  - BMJ
UR  - http://dx.doi.org/10.1136/bmj.39079.460741.7C
N2  - Objective: To examine the effectiveness of methods to
improve partner notification by patient referral (index
patient has responsibility for informing sex partners of
their exposure to a sexually transmitted infection).
Design: Systematic review of randomised trials of any
intervention to supplement simple patient referral.
Data sources: Seven electronic databases searched
(January 1990 to December 2005) without language
restriction, and reference lists of retrieved articles.
Review methods: Selection of trials, data extraction, and
quality assessment were done by two independent
reviewers. The primary outcome was a reduction of
incidence or prevalence of sexually transmitted
infections in index patients. If this was not reported data
were extracted according to a hierarchy of secondary
outcomes: number of partners treated; number of
partners tested or testing positive; and number of
partners notified, located, or elicited. Random effects
meta-analysis was carried out when appropriate.
Results: 14 trials were included with 12 389 women and
men diagnosed as having gonorrhoea, chlamydia, nongonococcal
urethritis, trichomoniasis, or a sexually
transmitted infection syndrome. All studies had
methodological weaknesses that could have biased
their results. Three strategies were used. Six trials
examined patient delivered partner therapy. Metaanalysis
of five of these showed a reduced risk of
persistent or recurrent infection in patients with
chlamydia or gonorrhoea (summary risk ratio 0.73, 95%
confidence interval 0.57 to 0.93). Supplementing
patient referral with information for partners was as
effective as patient delivered partner therapy. Neither
strategy was effective in women with trichomoniasis.
Two trials found that providing index patients with
chlamydia with sampling kits for their partners
increased the number of partners who got treated.
Conclusions: Involving index patients in shared
responsibility for the management of sexual partners
improves outcomes. Health professionals should
consider the following strategies for the management of
individual patients: patient delivered partner therapy,
home sampling for partners, and providing additional
information for partners.
ER  -