General information
Among 1549 and 2579 hospitals registered in Shandong province in 2012 and 2018, clinical service for STI were available in 410 (26.47%) and 496 (19.23%) hospitals, and a total of 403 and 478 valid questionnaires were collected in the two surveys, respectively. The coverage of different hospitals provided clinical services for STI was low and had been deteriorated from 2012 to 2018, excepting among specialized dermatological hospitals and maternal and child health hospitals. (Table 1)
Table 1
Percentages of surveyed hospitals in Shandong
Categories | | Number of hospitals in 2012 | Surveyed in 2012 (n, %) | Number of hospitals in 2018 | Surveyed in 2018 (n, %) | X2, p |
Total | | 1549 | 403(26.02) | 2579 | 478(18.53) | 32.276,0.000 |
Level | Class III hospitals | 127 | 116(91.34) | 182 | 119(65.38) | 27.666,0.000 |
| Class II and below hospitals | 1422 | 287(20.18) | 2397 | 359(14.98) | 17.376,0.000 |
Type | Specialized dermatological hospitals | 55 | 34(61.82) | 48 | 43(89.58) | 10.471,0.001 |
| General western medicine hospitals | 1099 | 219(19.93) | 1962 | 225(11.47) | 40.648,0.000 |
| Maternal and child health hospitals | 158 | 81(51.27) | 162 | 107(66.05) | 7.214,0.007 |
| Chinese medicine hospitals | 158 | 50(31.65) | 323 | 86(26.63) | 1.319,0.251 |
| Other specialized hospitals | 79 | 19(24.05) | 84 | 17(20.24) | 0.344,0.558 |
Affiliation | Public hospitals | 773 | 368(47.61) | 807 | 433(53.66) | 5.779,0.016 |
| Private hospitals | 776 | 35(4.51) | 1772 | 45(2.54) | 6.893,0.009 |
Availability of laboratory tests for NG in hospitals of Shandong province
Smear, culture and PCR tests for NG were used among 301 (74.69%), 123 (30.52%), 43 (10.67%) hospitals in 2012 and 356 (74.48%), 176 (36.82%) and 73 (15.27%) hospitals in 2018, respectively. Significant differences were observed in the availability of smear at different levels in 2018 (X2 = 12.159, p = 0.000), but not in 2012. Significant differences were observed in the availability of culture and PCR tests at different levels both in 2012 (X2 = 34.532, p = 0.000; X2 = 7.380, p = 0.007) and 2018 (X2 = 49.820, p = 0.000; X2 = 21.658, p = 0.000). They were more available in class III hospitals than class II and below hospitals. Significant differences were observed in the availability of smear, culture and PCR tests among different type of hospitals both in 2012 (X2 = 35.593, p = 0.000; X2 = 27.574, p = 0.000; X2 = 9.666, p = 0.046) and 2018 (X2 = 92.132, p = 0.000; X2 = 37.660, p = 0.000; X2 = 13.310, p = 0.016). Smear and culture tests were more available among specialized dermatological hospitals and general western medicine hospitals than among other kinds of hospitals in 2012 (X2 = 32.450, p = 0.000; X2 = 23.759, p = 0.000) and 2018 (X2 = 76.587, p = 0.000; X2 = 31.391, p = 0.000). PCR test was more available among general western medicine hospitals than among other kinds of hospitals in 2012 (X2 = 6.113, p = 0.013) and 2018 (X2 = 10.365, p = 0.001). Significant differences were observed in the availability of culture test among hospitals with different affiliations in 2018 (X2 = 4.551, p = 0.033), but not in 2012. Culture test was more available in public hospitals than private hospitals in 2018. No significant differences were observed in the availability of smear and PCR tests among hospitals with different affiliations both in 2012 and 2018.
No significant change in the availability of smear test for NG was observed among hospitals from 2012 to 2018 (X2 = 0.005, p = 0.942). The availability of culture test for NG among hospitals in 2018 was higher than that in 2012 (36.82% vs. 30.52%, X2 = 3.870, p = 0.049). It was significantly improved from 2012 to 2018 among general western medicine hospitals (36.99% vs. 47.11%, X2 = 4.667, p = 0.031) and public hospitals (30.71% vs. 38.34%, X2 = 5.103, p = 0.024). The availability of PCR test for NG among hospitals in 2018 was higher than that in 2012 (15.27% vs. 10.67%, X2 = 4.050, p = 0.044). It was significantly improved from 2012 to 2018 among class III hospitals (17.24% vs. 28.57%, X2 = 4.261, p = 0.039) and public hospitals (10.60% vs. 15.70%, X2 = 4.482, p = 0.034). (Table 2)
Table 2
Availability of NG laboratory tests in hospitals of Shandong province
Categories | | Smear | Culture | PCR |
| | 2012(n, %) | 2018(n, %) | X2, p | 2012(n, %) | 2018(n, %) | X2, p | 2012(n, %) | 2018(n, %) | X2, p |
Total | | 301(74.69) | 356(74.5) | 0.005,0.942 | 123(30.52) | 176(36.82) | 3.870,0.049 | 43(10.67) | 73(15.27) | 4.050,0.044 |
Level | Class III hospitals | 91(78.45) | 103(86.6) | 2.680,0.102 | 60(51.72) | 76(63.87) | 3.552,0.059 | 20(17.24) | 34(28.57) | 4.261,0.039 |
| Class II and below hospitals | 210(73.17) | 253(70.5) | 0.571,0.450 | 63(21.95) | 100(27.86) | 2.947,0.086 | 23(8.01) | 39(10.86) | 1,493,0.222 |
| X2, p | 1.217, 0.270 | 12.159,0.000 | | 34.532, 0.000 | 49.820,0.000 | | 7.380, 0.007 | 21.658,0.000 | |
Types | Specialized dermatological hospitals | 32(91.43) | 41(95.30) | 1.000 | 18(52.94) | 22(51.16) | 0.024,0.877 | 1(2.94) | 2(4.65) | 1.000 |
| General western medicine hospitals | 181(82.65) | 200(88.90) | 3.550,0.060 | 81(36.99) | 106(47.11) | 4.667,0.031 | 31(14.16) | 47(20.89) | 3.475,0.062 |
| Maternal and child health hospitals | 46(56.79) | 48(44.90) | 2.625,0.105 | 12(14.81) | 16(14.95) | 0.001,0.979 | 4(4.94) | 12(11.21) | 2.333,0.127 |
| Chinese medicine hospitals | 31(62.00) | 59(68.60) | 0.616,0.432 | 8(16.00) | 26(30.23) | 3.416,0.065 | 6(12.00) | 11(12.79) | 0.018,0.893 |
| Other specialized hospitals | 11(57.89) | 8(47.10) | 0.423,0.516 | 4(21.05) | 6(35.29) | 0.463 | 1(5.26) | 1(5.88) | 1.000 |
| X2, p | 35.593, 0.000 | 92.132,0.000 | | 27.574,0.000 | 37.660,0.000 | | 9.666,0.046 | 13.310,0.016 | |
Affiliation | Public hospitals | 278(75.54) | 325(75.10) | 0.025,0.874 | 113(30.71) | 166(38.34) | 5.103,0.024 | 39(10.60) | 68(15.70) | 4.482,0.034 |
| Private hospitals | 23(65.71) | 31(68.90) | 0.090,0.764 | 10(28.57) | 10(22.22) | 0.423,0.515 | 4(11.43) | 5(11.11) | 1.000 |
| X2, p | 1.633, 0.201 | 0.816,0.654 | | 0.069, 0.793 | 4.551,0.033 | | 0.023,0.880 | 0.665,0.415 | |
Distribution and change of hospitals with gonorrhea laboratory tests and cases reporting in Shandong province
A total of 119 (29.53%) and 188 (39.33%) hospitals reported gonorrhea cases in 2012 and 2018, respectively. A significant difference was observed in distribution of case reporting among hospitals with different level in 2018 (X2 = 6.975, p = 0.008), but not in 2012 (X2 = 3.491, p = 0.062). More class III hospitals reported gonorrhea cases than class II and below hospitals in 2018. A significant difference was observed in distribution of case reporting among different type of hospitals both in 2012 (X2 = 52.362, p = 0.000) and 2018 (X2 = 74.478, p = 0.000). More specialized dermatological hospitals reported gonorrhea cases than other hospitals in 2012 (X2 = 18.543, p = 0.000). More specialized dermatological hospitals and general western medicine hospitals reported gonorrhea cases than other hospitals in 2018 (X2 = 58.654, p = 0.000). No significant differences were observed in distribution of case reporting among hospitals with different affiliations both in 2012 (X2 = 2.826, p = 0.093) and 2018 (X2 = 3.339, p = 0.068).
More hospitals reported gonorrhea cases in 2018 than in 2012 (X2 = 6.768, p = 0.009). Specifically, more class III hospitals, class II and below hospitals, general western medicine hospitals and public hospital reported gonorrhea cases in 2018 than in 2012 (X2 = 4.286, p = 0.038; X2 = 6.086, p = 0.014; X2 = 15.520, p = 0.000; X2 = 8.523, p = 0.004). (Table 3)
Table 3
Distribution and change of hospitals with gonorrhea cases reporting in Shandong province
Categories | | Hospital with case reporting in 2012(n, %) | Hospital with case reporting in 2018(n, %) | X2, p |
Total | | 119(29.53) | 188(39.33) | 6.768,0.009 |
Level | Class III hospitals | 42(36.21) | 59(76.47) | 4.286,0.038 |
| Class II and below hospitals | 77(26.83) | 129(49.58) | 6.086,0.014 |
| X2, p | 3.491,0.062 | 6.975,0.008 | |
Types | Specialized dermatological hospitals | 21(61.76) | 24(55.81) | 0.277,0.599 |
| General western medicine hospitals | 78(35.62) | 122(54.22) | 15.520,0.000 |
| Maternal and child health hospitals | 3(3.70) | 9(8.41) | 1.710,0.191 |
| Chinese medicine hospitals | 16(32.00) | 31(36.05) | 0.229,0.632 |
| Other specialized hospitals | 1(5.26) | 2(11.76) | 0.593 |
| X2, p | 52.362,0.000 | 74.478,0.000 | |
Affiliation | Public hospitals | 113(30.71) | 176(40.65) | 8.523,0.004 |
| Private hospitals | 6(17.14) | 12(26.67) | 1.024,0.312 |
| X2, p | 2.826,0.093 | 3.339,0.068 | |
Among hospitals reported cases of gonorrhea in 2018, 95 reported female gonorrhea cases. More hospitals with culture or PCR tests available reported female cases of gonorrhea than those without (67.37% vs. 32.63%; X2 = 7.733, p = 0.005).