Infecciones de transmisión sexual: Concordancia diagnóstica entre profesionales de atención primaria de la zona norte de Santiago y dermatólogos del Hospital San José

Introduction: Sexually transmitted infections (STI) are a public health priority because of its high prevalence, economic repercussions and impact on quality of life. Currently, there are no reports that analyse the diagnostic agreement of STI between primary and secondary health care professionals. Objective: To analyse the diagnostic concordance of STI amongst primary and secondary health care professionals. Methodology: Data from 627 patients that were referred according to referral and counter-referral diagnosis from Primary Health Care (PHC) of the northern zone of Santiago to San Jose Hospital´s Sexual Health Attention and Control Unit (UNACESS) during January 2015 until January 2016 was analyzed. The referring physician, patients’ sex and age was taken into consideration. The level of diagnostic concordance was determined by the Cohen’s kappa coefficient. Results : From the PHC consultations, 74% were issued by midwives and 26% by doctors. The predominant referral diagnoses were: Condyloma acuminatum (64.43%), molluscum contagiosum (8.13%), syphilis (7.34%), urethritis (7.02%) and genital herpes (3.67%). The prevalent counter-referral diagnoses were: condylomas (51.20%), syphilis (10.85%), molluscum contagiosum (10.37%), urethritis (6.86%), and genital herpes (3.51%). The study’s overall diagnostic concordance was moderate (54%). PHC physicians achieved a substantial concordance (62%) and midwives had a moderate concordance (49.19%) to the diagnoses made by the specialist. Conclusion: There is a moderate diagnostic concordance between the PHC professionals and the specialists’ doctors. It is crucial to reinforce STI training and develop training strategies for general physicians and PHC midwives.