Chlamydia at an inner metropolitan sexual health service in Sydney, NSW: Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) Project
Neil Franklin A , Catherine C. O’Connor E H I , Miranda Shaw E , Rebecca Guy A , Andrew Grulich A , Christopher K. Fairley B , Marcus Y. Chen B , Margaret Hellard C , Bridget Dickson D , Lewis Marshall F , Basil Donovan A G and on behalf of the ACCESS CollaborationA National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW 2010, Australia.
B School of Population Health, University of Melbourne, and Melbourne Sexual Health Centre, Melbourne, Vic. 3053, Australia.
C Centre for Population Health, Macfarlane Burnett Institute for Medical Research and Public Health, Melbourne, Vic. 3000, Australia.
D CaraData Pty Ltd, Parkwood, Qld 4214, Australia.
E Sexual Health Service, Community Health, RPA Hospital, SSWAHS, Camperdown, NSW 2050, Australia.
F Fremantle Hospital, Fremantle, WA 6969, Australia.
G Sydney Sexual Health Centre, Sydney Hospital, Liverpool, NSW 2170, Australia.
H South-Western Clinical School, The University of New South Wales, Sydney, NSW 2052, Australia.
I Corresponding author. Email: oconnorc@email.cs.nsw.gov.au
Sexual Health 7(4) 478-483 https://doi.org/10.1071/SH09125
Submitted: 22 November 2009 Accepted: 11 May 2010 Published: 10 November 2010
Abstract
Background: Australia has a widely dispersed network of public sexual health services that test large numbers of people from high prevalence populations for genital Chlamydia trachomatis infection. These populations include young sexually active heterosexuals, men who have sex with men, sex workers and Aboriginal and Torres Strait Islander people. The Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) Project was established to monitor chlamydia testing rates and positivity rates at a national level, which in turn will help interpret trends in chlamydia diagnoses reported through passive surveillance. The ACCESS Project is the first time that chlamydia-related data including priority population and testing denominators has been collated at a national level. The present paper reports on chlamydia testing and positivity rates in a sexual health service in the inner west of Sydney between 2004 and 2008 and compares these to published national data from the ACCESS Project in sexual health services. Methods: Chlamydia positivity and testing rates at an inner western Sydney sexual health service were compared with aggregate data from the ACCESS Project obtained from 14 sexual health services across Australia. Using a standardised extraction program, retrospective de-identified line-listed demographic and chlamydia testing data on all patients were extracted from patient management systems. Results: Over the 5-year period, 5145 new patients attended the inner-west sexual health service. Almost 66% had a chlamydia test at first visit and there was no significant difference in this testing rate when compared with the ACCESS Project national rate for sexual health services (67.0%; odds ratio [OR] 0.94, 95% confidence intervals 0.88–1.00). The testing rate increased over time from 61% in 2004 to 70% in 2008. There were 281 chlamydia diagnoses at this service, giving an overall chlamydia positivity rate of 9.3%, significantly higher than the ACCESS Project national rate of 8.2% (OR 1.16, 95% confidence intervals 1.02–1.32). Discussion: Testing rates were similar and positivity rates for Chlamydia trachomatis were higher in this sexual health service in Sydney than national trends.
Additional keywords: STI testing.
Acknowledgements
ACCESS is a collaboration between the National Centre in HIV Epidemiology and Clinical Research, the Burnet Institute, the National Serology Reference Library, and the National Perinatal Statistics Unit. It is funded by the Department of Health and Ageing, as part of the national Chlamydia Pilot Program. The Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) is funded through the Australian Government Department of Health and Ageing Chlamydia Pilot Program.
Professor Basil Donovan, Dr Rebecca Guy, Professor Andrew Grulich, Professor John Kaldor, Neil Franklin, the National Centre in HIV Epidemiology and Clinical Research, Sydney, NSW; Dr Christopher Fairley (Chair), Dr Marcus Chen, Melbourne Sexual Health Clinic, Melbourne, Vic.; Bridget Dickson, Caradata, Parkwood, Qld; Dr Lewis Marshall, WA Sexual Health Services, Fremantle, WA; Associate Professor Catherine O’Connor, Committee of Medical Directors of NSW Sexual Health Services, Sydney, NSW; Associate Professor Margaret Hellard, Burnett Institute, Melbourne, Vic.
Dr Kelaart, Mairead Hetherington, Alice Springs Clinic 34, Alice Springs, NT; Professor Frank Bowden, Dr Sarah Martin, Canberra Sexual Health Centre, Canberra, ACT; Dr Nathan Ryder, Heng Lu, Sydney Sexual Health Centre, Sydney, NSW; Dr Brian Mulhall, Amanda Rickett , Coffs Harbour Sexual Health, Coffs Harbour, NSW; Peter Knibbs, Dr Catherine Pell, Darwin Clinic 34, Darwin, NT; Associate Professor Darren Russell, Sandra Downing, Dolls House Sexual Health Clinic, Cairns, Qld; Dr Lewis Marshall, Fremantle Hospital, Fremantle, WA; Dr John Chua, May Ngieng, Gold Coast Sexual Health, Gold Coast, Qld; Michael Bolton, Alison Kincaid, Greater Southern Area Health Service, NSW; Dr Maree O’Sullivan, Houlihan Nives, Hobart Sexual Health Service, Hobart, Tas.; Dr Debbie Allen, Paul Maudlin, Holden St Sexual Health Centre, Gosford, NSW; Dr Catriona Ooi, Martin O’Connor, Hunter New England Sexual Health Service, Newcastle, NSW; Dr Ingrid Van Beek, Dr Craig Rogers, Heng Lu, Kirketon Road Centre, Sydney, NSW; Dr David J Smith, Cecily Gray, Lismore/Tweed Heads Sexual Health Service, Lismore, NSW; Christopher Fairley, Marcus Chen, A Afrizal, Melbourne Sexual Health Centre, Melbourne, Vic.; Tim lynch, Fiona D’Aquino, Orange Sexual Health Centre, Orange, NSW; David Jardine, Dee Archbold, Princess Alexandra Sexual Health, South Brisbane, Qld; Associate Professor Catherine O’Connor, Seven Guney, RPA Sexual Health Clinic, Camperdown, NSW; Dr Stephen Davies, Amanda Rickett, Royal North Shore Hospital Sexual Health, North Sydney, NSW; Dr Katerina Lagios, Sangeetha Eswarappa, SWAHS: Eastern Division, NSW; Jane Shakeshaft, SWAHS: Western Division, NSW; Associate Professor Katherine Brown, Victoria McGrath, Sydney South Illawarra Health Service, Wollongong, NSW; Dr Pam Konecny, Heng Lu, St George Short St Sexual Health Centre, Kogarah, NSW; Dr Arun Menon, Angela Cooper, Townsville Sexual Health Service, Townsville, Qld.
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