{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T14:44:10Z","timestamp":1761489850590},"reference-count":31,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,11,2]]},"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Assessment of the relations between recorded gonorrhoea rates and clinical testing activity and disposable diagnostic tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In Denmark, two sources of information on the epidemiology of gonorrhoea are available: (1) a mandatory clinical notification system (since 1867) comprising summary information about geographic distribution, season, age group and gender; in 1994, more detailed anonymous individualised epidemiological information was included; (2) a voluntary countrywide laboratory surveillance system for culture-confirmed cases (since 1957) comprising information about patient's age and gender, infected anatomical sites and medical setting attended.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both surveillance systems showed marked simultaneous changes in gonorrhoea rates, although periodically considerable under-reporting or under-diagnosing was demonstrated. The annual incidence of notified cases peaked in 1919 (474\/100\u2005000), in 1944 (583\/100\u2005000) and in 1972 (344\/100\u2005000). Since 1995, the incidence has been at a low endemic level (1.5\u201310\/100\u2005000) and the total male\/female incidence ratios were from 3 to 7 times higher than previously recorded. Among approximately 2 million persons tested during 1974\u20131988 78\u2005213 men and 63\u2005143 women with culture-confirmed gonorrhoea were identified. During this period, pharyngeal sampling was performed in 36% of men and 25% of women with gonorrhoea; pharyngeal gonorrhoea was found in 10% and 16%, respectively; 40% and 30% of these patients had no concomitant urogenital gonorrhoea. Among men with gonorrhoea, 34% were sampled from the rectum; 9% had rectal gonorrhoea, among whom the rectum was the only infected site in 67%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Crucial factors for case finding are clinical sampling tradition and appropriate laboratory diagnostic facilities. When case finding is insufficient, a reservoir of asymptomatic rectal or pharyngeal gonorrhoea remains unrecognised.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2015-008013","type":"journal-article","created":{"date-parts":[[2015,12,1]],"date-time":"2015-12-01T03:09:58Z","timestamp":1448939398000},"page":"e008013","update-policy":"http:\/\/dx.doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Recorded gonorrhoea rates in Denmark, 1900\u20132010: the impact of clinical testing activity and laboratory diagnostic procedures"],"prefix":"10.1136","volume":"5","author":[{"given":"Inga","family":"Lind","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steen","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,11,30]]},"reference":[{"key":"2024051513585067000_5.11.e008013.1","unstructured":"The National Health Service. 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