Establishment of a sentinel surveillance network for sexually transmissible infections and blood borne viruses in Aboriginal primary care services across Australia: the ATLAS project

Abstract

Background Sexually transmissible infection (STI) and blood-borne virus (BBV) notification data is a mainstay of the Australian National Notifiable Diseases Surveillance System (NNDSS) and is a mandatory requirement in all Australian jurisdictions. The system focuses on STI and BBV diagnoses alone, without testing, treatment or management data, leaving major gaps in the understanding of epidemics, especially among priority populations like Aboriginal and Torres Strait Islander peoples. Further information is required to supplement the NNDSS to better understand epidemics, the impact of interventions and health care delivery against clinical guidelines. Here we describe the rationale, processes and expected outcomes of establishing a national STI and BBV sentinel surveillance network in Aboriginal primary care services—known as the ATLAS network.Methods Researchers invited participation and consultation with Aboriginal Community-Controlled Health Services (ACCHS) clustered in five clinical hubs across four jurisdictions, representative of urban, regional and remote regions. Site-specific participation agreements were developed for each clinical hub and individual ACCHS. De-identified electronic medical record (EMR) data relating to STI and BBV testing, treatment and care are collected passively from each health service via the GRHANITE tm data extraction tool. These data are analysed centrally to inform 12 performance indicators which are included in surveillance reports generated for each health service and clinical hub.Results The ATLAS network currently involves 29 ACCHS representing all five clinical hubs. The ATLAS network provides detailed surveillance reports to individual ACCHS as well as contributing to aggregate comparative analyses at the clinical hub, jurisdictional and national levels. Data derived from the ATLAS network is used to assess clinical practice within each site. Aggregated data will inform clinical guidelines and extend the research potential of participating ACCHS sites. The ATLAS infrastructure can be expanded to include other health services and potentially linked to other data sources using GRHANITE.Conclusions The ATLAS network will supplement the NNDSS and contribute to improved understanding of local, regional and national patterns of clinical care of STI and BBV to inform clinical practice, policy, and program-planning.

The search for evidence in Indigenous health intervention research: Shifting the debate

“…28 This collaborative, mutually-beneficial model for Indigenous data collection has been replicated in studies such as the ATLAS project and its application to other Indigenous health contexts merits further consideration. 29 5. Finally, we need to move beyond traditional systematic reviews in Indigenous health research, in favour of approaches that are more inclusive of diverse and culturally appropriate forms of evidence.…”

Hepatocellular carcinoma in Indigenous Australians: a call to action

“…At a public health level, recognising high rates of HCC incidence and mortality in Indigenous populations is critical to change the narrative into a positive plan, designed and led by Indigenous people. There is an urgent need for standardised data collection on liver disease and liver cancer among Indigenous Australians, building on existing surveillance networks, such as the NT Hep B Hub 16 (a care facilitation tool to ensure all Indigenous Australians living in the NT are tested for hepatitis B and people with hepatitis B linked to and maintained in care) and the ATLAS network 17 (a sentinel surveillance network for sexually transmissible diseases and blood‐borne viruses in Aboriginal primary care services). Liver disease should be prioritised on revised Close the Gap agendas and Indigenous health strategies.…”