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High chlamydia and gonorrhoea repeat positivity in remote Aboriginal communities 20092011: longitudinal analysis of testing for re-infection at 3 months suggests the need for more frequent screening

High chlamydia and gonorrhoea repeat positivity in remote Aboriginal communities 20092011:... BackgroundExtremely high rates of diagnosis of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) have been recorded in remote communities across northern and central Australia. Re-testing at 3 months, after treatment administered, of CT or NG is recommended to detect repeat infections and prevent morbidity and ongoing transmission. Methods: Baseline CT and NG laboratory data (20092010) from 65 remote health services participating in a cluster randomised trial was used to calculate the proportion of individuals re-tested after an initial CT or NG diagnosis at <2 months (not recommended), 24 months (recommended) and 512 months and the proportion with repeat positivity on re-test. To assess if there were difference in re-testing and repeat positivity by age group and sex, t-tests were used. Results: There was a total of 2054 people diagnosed with CT and/or NG in the study period 14.9% were re-tested at 24 months, 26.9% at 512 months, a total of 41.8% overall. Re-testing was higher in females than in males in both the 24-month (16.9% v. 11.5%, P<0.01) and 512-month (28.9% v. 23.5%, P=0.01) periods. Women aged 2529 years had a significantly higher level of re-testing 512 months post-diagnosis than females aged 1619 years (39.8% v. 25.4%, P<0.01). There was a total of 858 people re-tested at 212 months and repeat positivity was 26.7%. There was higher repeat NG positivity than repeat CT positivity (28.8% v. 18.1%, P<0.01). Conclusions: Just under half the individuals diagnosed with CT or NG were re-tested at 212 months post-diagnosis however, only 15% were re-tested in the recommended time period of 24 months. The higher NG repeat positivity compared with CT is important, as repeat NG infections have been associated with higher risk of pelvic inflammatory disease-related hospitalisation. Findings have implications for clinical practice in remote community settings and will inform ongoing sexual health quality improvement programs in remote community clinics. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Sexual Health CSIRO Publishing

High chlamydia and gonorrhoea repeat positivity in remote Aboriginal communities 20092011: longitudinal analysis of testing for re-infection at 3 months suggests the need for more frequent screening

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References (27)

Publisher
CSIRO Publishing
Copyright
Copyright © The Author(s). Published by CSIRO Publishing
ISSN
1448-5028
eISSN
1449-8987
DOI
10.1071/SH16025
pmid
27764650
Publisher site
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Abstract

BackgroundExtremely high rates of diagnosis of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) have been recorded in remote communities across northern and central Australia. Re-testing at 3 months, after treatment administered, of CT or NG is recommended to detect repeat infections and prevent morbidity and ongoing transmission. Methods: Baseline CT and NG laboratory data (20092010) from 65 remote health services participating in a cluster randomised trial was used to calculate the proportion of individuals re-tested after an initial CT or NG diagnosis at <2 months (not recommended), 24 months (recommended) and 512 months and the proportion with repeat positivity on re-test. To assess if there were difference in re-testing and repeat positivity by age group and sex, t-tests were used. Results: There was a total of 2054 people diagnosed with CT and/or NG in the study period 14.9% were re-tested at 24 months, 26.9% at 512 months, a total of 41.8% overall. Re-testing was higher in females than in males in both the 24-month (16.9% v. 11.5%, P<0.01) and 512-month (28.9% v. 23.5%, P=0.01) periods. Women aged 2529 years had a significantly higher level of re-testing 512 months post-diagnosis than females aged 1619 years (39.8% v. 25.4%, P<0.01). There was a total of 858 people re-tested at 212 months and repeat positivity was 26.7%. There was higher repeat NG positivity than repeat CT positivity (28.8% v. 18.1%, P<0.01). Conclusions: Just under half the individuals diagnosed with CT or NG were re-tested at 212 months post-diagnosis however, only 15% were re-tested in the recommended time period of 24 months. The higher NG repeat positivity compared with CT is important, as repeat NG infections have been associated with higher risk of pelvic inflammatory disease-related hospitalisation. Findings have implications for clinical practice in remote community settings and will inform ongoing sexual health quality improvement programs in remote community clinics.

Journal

Sexual Health – CSIRO Publishing

Published: Oct 21, 2016

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