Evidence of Thorough Reporting of Sexually Transmitted Diseases in a Southern Rural County

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Abstract
Private physicians outside the South have been found to report half or fewer of the sexually transmitted diseases that they diagnose. The authors studied whether this is also true in a Southern rural county. Reports of gonorrhea and chlamydia infection from private physician practices in a rural North Carolina county were compared with laboratory records of positive test results. The proportions reported through 8 months of passive surveillance were compared with the proportion reported during 2 months of active weekly telephone surveillance. A total of 72% of all positive gonorrhea test results and 55% of all chlamydia test results were reported through passive surveillance. The proportions increased to 88% and 79%, respectively, with active surveillance. A separate system of multiple checks ensured complete reporting of syphilis that was not affected by surveillance type. A relatively high proportion of sexually transmitted diseases diagnosed by private physicians was reported in this rural county. Potential reasons included physician awareness of reporting requirements, delegation of reporting to clinical staff, and personal acquaintance with the health department staff.

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