Improvement in antenatal testing for sexually transmissible infections and blood-borne viruses in Western Australian hospitals, 2007 to 2010
Kellie S. H. Kwan A , Carolien M. Giele A , Barry Combs A and Donna B. Mak A B
+ Author Affiliations
- Author Affiliations
A Communicable Disease Control Directorate, Department of Health, Western Australia, PO Box 8172, Perth Business Centre, WA 6849, Australia.
B Corresponding author. Email: donna.mak@health.wa.gov.au
Sexual Health 9(4) 349-354 https://doi.org/10.1071/SH11151
Submitted: 3 November 2011 Accepted: 24 January 2012 Published: 11 May 2012
Abstract
Objective: Antenatal testing for specified sexually transmissible infections (STIs) and blood-borne viruses (BBVs) is recommended by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). In 2007, the Department of Health, Western Australia (DoHWA) issued an operational directive (OD) recommending universal testing for chlamydia and additional testing for women in the STI endemic regions of Western Australia (WA). To assess adherence to these guidelines, seven WA public hospitals were audited. Design and setting: Demographic details and testing information of the last 200 women who gave birth immediately before 30 June 2007 (baseline audit) and 30 June 2010 (follow-up audit) were obtained from each hospital’s antenatal records. Results: Data from 2718 women who delivered at ≥36 weeks’ gestation were analysed (baselinen = 1353; follow-upn = 1365). Testing at the first antenatal visit in accordance with the guidelines improved over time (RANZCOG: 68–74%; χ2-test = 13.96, d.f. = 1, P < 0.001; DoHWA OD: 12–40%; χ2-test = 279.71, d.f. = 1, P < 0.001). Retesting at 28–36 weeks’ gestation in the STI endemic regions improved for chlamydia (3–10%; χ2-test = 17.40, d.f. = 1, P < 0.001) and gonorrhoea (3–7%; χ2-test = 6.62, d.f. = 1, P < 0.05), but not for syphilis or HIV. Chlamydia prevalence was 3% and 8% among nonAboriginal and Aboriginal women, respectively. Conclusion: The proportion of women delivering in WA public hospitals who had antenatal STI and BBV tests improved after publication and promotion of the OD.
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