The highs and lows of opportunistic Chlamydia testing: uptake and detection in Waikato, New Zealand

Morgan, Jane; Bell, Anita

doi:10.1136/sti.2009.035964

Cited by 9 publications

(9 citation statements)

References 7 publications

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“…Data from the much bigger Waikato pilot found there was much lower chlamydia test uptake in males than in females. 6 In contrast to the Waikato pilot and other data, 2 we did not find the prevalence of chlamydia to be higher in those of Maori and Pacific ethnicity compared with Europeans.…”

Section: Discussioncontrasting

confidence: 98%

“…Data from the Waikato pilot confirmed a lower test uptake in males. 6 The Auckland pilot had multiple aims and objectives. This paper describes outcomes of two aims: firstly, to increase opportunistic testing for chlamydia in those aged under 25 years (particularly males) and, secondly, to improve documentation of follow-up and partner notification of diagnosed cases.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Large increase in opportunistic testing for chlamydia during a pilot project in a primary health organisation

Azariah¹,

McKernon²,

Werder³

2013

J Prim Health Care

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INTRODUCTION: The Auckland chlamydia pilot project was one of three funded by the Ministry of Health to trial implementation of the 2008 Chlamydia Management Guidelines. Chlamydia is the most commonly notified sexually transmitted infection in New Zealand. AIM: To increase opportunistic testing in under-25-year-olds and to improve documentation of partner notification in primary care. METHODS: A four-month pilot was initiated in Total Healthcare Otara using a nurse-led approach. Laboratory testing data was analysed to assess whether the pilot had any impact on chlamydia testing volumes in the target age-group. Data entered in the practice management system was used to assess follow-up and management of chlamydia cases. RESULTS: During the pilot there was a 300% increase in the number of chlamydia tests in the target age-group from 812 to 2410 and the number of male tests increased by nearly 500%. Twenty-four percent of people tested were positive for chlamydia, with no significant difference in prevalence by ethnicity. The pilot resulted in better documentation of patient follow-up in the patient management system. DISCUSSION: There was a large increase in chlamydia testing during the pilot with a high prevalence found in the population tested. Chlamydia remains an important health problem in New Zealand. The cost benefit of increased chlamydia screening at a population level has yet to be established. KEYWORDS: Chlamydia; notification, partner; pilot project; prevalence; primary health care

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Section: Discussioncontrasting

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Large increase in opportunistic testing for chlamydia during a pilot project in a primary health organisation

Azariah¹,

McKernon²,

Werder³

2013

J Prim Health Care

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“…Details of this analysis have been reported elsewhere. 9 In summary, baseline chlamydia test uptake for women under 25 years of age was much higher than expected and with similar testing rates for Maori and non-Maori. Among tests from 15-to 24-year-old females, 14% of tests were positive with positivity double amongst Maori, 24.2% vs 12.5%.…”

Section: Improving Performancementioning

confidence: 65%

“…Among tests from 15-to 24-year-old females, 14% of tests were positive with positivity double amongst Maori, 24.2% vs 12.5%. 9 Discussions were held with a group of 15 GPs from both rural and urban settings and with a group of five rural-based practice nurses around opportunistic testing for chlamydia. Participants reported existing awareness of chlamydia as a significant issue and that they were 'already testing' young women, supporting findings from the baseline test analysis.…”

Section: Improving Performancementioning

confidence: 99%

Does a clinical guideline change chlamydia testing? Report from the Waikato Chlamydia Project

Morgan

Donnell²,

Bell³

2012

J Prim Health Care

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BACKGROUND AND CONTEXT: Waikato District Health Board was one of three districts chosen to implement a national chlamydia management guideline, with the aim of optimising testing and treatment. Previous New Zealand studies suggest any test increases associated with such an intervention may be short-lived. ASSESSMENT OF PROBLEM: District-wide chlamydia test volumes were compared for three periods, before (JuneNov 2008), during (JuneNov 2009) and after (JuneNov 2010) guideline implementation by age, gender and ethnicity. Crude estimates of population test uptake were calculated. Azithromycin pharmacy claim volumes were assessed as a measure of treatment. RESULTS: Chlamydia test uptake for women was already high, with 23% of 15- to 24-year-old women tested during the period from June to November 2008. Although tests from under-25-year-olds increased during implementation in 2009, the change was not significant and was not sustained in 2010, p=0.06. Similarly, there were no significant sustained changes by gender or ethnicity following implementation. STRATEGIES FOR IMPROVEMENT: This includes a continued emphasis on optimal chlamydia case finding and treatment by focusing on those at greater risk of infection. Efforts to improve partner notification should be instigated which may in turn better engage men around sexual health. LESSONS: Local data should be used to identify local issues. There is a need to determine whether <25 years is the optimal age threshold for targeted chlamydia testing in New Zealand and to ensure appropriate resources, training and support are in place for primary care nurses who play a pivotal role in sexual health care delivery. Keywords: Chlamydia trachomatis; mass screening; practice guidelines; primary health care; contact tracing

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“…3,4 Recent efforts locally have therefore focused on improving district-wide primary sexual health-care provision for young people, with free general practice visits introduced in high-need areas during 2003–2004. 5 Encouragingly, chlamydia test uptake within Waikato DHB is now equitable by ethnicity, with high rates of testing among both Māori and non-Māori women under 25 years old, 6 and coverage for young women reached 45% in 2009. However, improved access to testing without ensuring equitable access to effective treatment or partner notification means that disparities in health outcomes will likely persist.…”

Section: Introductionmentioning

confidence: 99%

Is everyone treated equally? Management of genital Chlamydia trachomatis infection in New Zealand

2010

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Health disparities often reflect inequitable access to appropriate health care. This study aimed to establish if cases of genital chlamydia infection were managed equitably by age, gender and ethnicity in a region of New Zealand with high rates of chlamydia infection (858 per 100,000 population). Clinical records of 415 genital chlamydia cases from 19 different health-care sites, including general practice and community settings, were reviewed. Data were analysed by demographic variables. For those treated, men were treated more quickly than women (median 3 days versus 6 days, P < 0.001), but there was no difference by ethnicity. Cases without documented treatment were more likely to be women (8.2% versus 2.1%, P = 0.037) and more likely to be Māori than non-Māori (13.6% versus 4.8%, P = 0.036). Overall, the most notable issue was the lack of effective partner notification across all demographic variables. Ongoing efforts are required to ensure equitable access to timely treatment and to ensure that more effective partner notification strategies are implemented.

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The highs and lows of opportunistic Chlamydia testing: uptake and detection in Waikato, New Zealand

Cited by 9 publications

References 7 publications

Large increase in opportunistic testing for chlamydia during a pilot project in a primary health organisation

Large increase in opportunistic testing for chlamydia during a pilot project in a primary health organisation

Does a clinical guideline change chlamydia testing? Report from the Waikato Chlamydia Project

Is everyone treated equally? Management of genital Chlamydia trachomatis infection in New Zealand

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