Partner notification services of the Sexually Transmitted Disease clinics in Sri Lanka

Abstract

Introduction: Partner notification is a strategy used to control sexually transmitted infections (STI). It includes identifying a look-back interval and offering testing and treatment to the relevant sexual partners of an index patient. Objective: Study was carried out to assess partner notification (PN) services at selected Sexually Transmitted Disease (STD) clinics. Method: Study consisted of four components. Component 1 was a cross sectional descriptive study among the staff of five selected STD clinics who were directly involved in PN, to assess knowledge, attitudes and practices on PN. Component 2 was a retrospective descriptive study in the same setting to describe the burden of partner notifiable STIs during 2012. Component 3 was a case-control study among patients with partner notifiable STIs in the STD clinic, Colombo during 2012 to describe factors associated with patient compliance in PN. Component 4 was a cross sectional study at STD clinic, Colombo to evaluate PN indices. Results: All interviewed staff knew that gonorrhoea, early syphilis and chlamydia infection are partner notifiable but some misidentified bacterial vaginosis (20%) and vaginal candidiasis (14%) as partner notifiable. Knowledge on contact actions and look back period were unsatisfactory and 17% and 10% respectively were unaware that look back period is irrelevant to genital herpes and genital warts. A total of 1,157 partner notifiable STIs have been reported from all five clinics in 2012. Patient compliance in PN was significantly associated with regular partners, NGI and coitarche ≥ 19 years. Percentages of index cases interviewed for PN and index cases who had documented outcomes for all contacts were only 30.7% and 8.1% respectively. Conclusions: Knowledge, attitude and practices on PN among the clinic staff was unsatisfactory. Percentage of index cases interviewed was low (30%) probably leaving a considerable number of contacts unattended. Patient compliance on PN was significantly associated with regular partners, coitarche ≥ 19 years and NGI. Documentation relevant to PN was unsatisfactory.