Belinda Hengel1, Handan Wand2, James Ward3, Alice Rumbold4, Linda Garton5, Debbie Taylor-Thomson4, Bronwyn Silver4, Skye McGregor2, Amalie Dyda2, Jacqueline Mein1, Janet Knox6, Lisa Maher2, John Kaldor2, Rebecca Guy2. 1. Apunipima Cape York Health Council, Cairns, PO Box 12045, Earlville, Qld 4870, Australia. 2. Kirby Institute, UNSW Australia, Wallace Wurth Building, Kensington, NSW 2052, Australia. 3. South Australian Health and Medical Research Institute, North Terrace Adelaide, SA 5000, Australia. 4. Menzies School of Health Research, Darwin, NT 0810, Australia. 5. NT Department of Health, Sexual Health and Blood Borne Virus Unit, Casuarina, NT 0811, Australia. 6. Lismore Sexual Health Service, NSW Health, Sydney, NSW, 2480, Australia.
Abstract
BACKGROUND: In high-incidence Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) settings, annual re-testing is an important public health strategy. Using baseline laboratory data (2009-10) from a cluster randomised trial in 67 remote Aboriginal communities, the extent of re-testing was determined, along with the associated patient, staffing and health centre factors. METHODS: Annual testing was defined as re-testing in 9-15 months (guideline recommendation) and a broader time period of 5-15 months following an initial negative CT/NG test. Random effects logistic regression was used to determine factors associated with re-testing. RESULTS: Of 10559 individuals aged ≥16 years with an initial negative CT/NG test (median age=25 years), 20.3% had a re-test in 9-15 months (23.6% females vs 15.4% males, P<0.001) and 35.2% in 5-15 months (40.9% females vs 26.5% males, P<0.001). Factors independently associated with re-testing in 9-15 months in both males and females were: younger age (16-19, 20-24 years); and attending a centre that sees predominantly (>90%) Aboriginal people. Additional factors independently associated with re-testing for females were: being aged 25-29 years, attending a centre that used electronic medical records, and for males, attending a health centre that employed Aboriginal health workers and more male staff. CONCLUSIONS: Approximately 20% of people were re-tested within 9-15 months. Re-testing was more common in younger individuals. Findings highlight the importance of recall systems, Aboriginal health workers and male staff to facilitate annual re-testing. Further initiatives may be needed to increase re-testing.
RCT Entities:
BACKGROUND: In high-incidence Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) settings, annual re-testing is an important public health strategy. Using baseline laboratory data (2009-10) from a cluster randomised trial in 67 remote Aboriginal communities, the extent of re-testing was determined, along with the associated patient, staffing and health centre factors. METHODS: Annual testing was defined as re-testing in 9-15 months (guideline recommendation) and a broader time period of 5-15 months following an initial negative CT/NG test. Random effects logistic regression was used to determine factors associated with re-testing. RESULTS: Of 10559 individuals aged ≥16 years with an initial negative CT/NG test (median age=25 years), 20.3% had a re-test in 9-15 months (23.6% females vs 15.4% males, P<0.001) and 35.2% in 5-15 months (40.9% females vs 26.5% males, P<0.001). Factors independently associated with re-testing in 9-15 months in both males and females were: younger age (16-19, 20-24 years); and attending a centre that sees predominantly (>90%) Aboriginal people. Additional factors independently associated with re-testing for females were: being aged 25-29 years, attending a centre that used electronic medical records, and for males, attending a health centre that employed Aboriginal health workers and more male staff. CONCLUSIONS: Approximately 20% of people were re-tested within 9-15 months. Re-testing was more common in younger individuals. Findings highlight the importance of recall systems, Aboriginal health workers and male staff to facilitate annual re-testing. Further initiatives may be needed to increase re-testing.
Authors: Praveena Gunaratnam; Gill Schierhout; Jenny Brands; Lisa Maher; Ross Bailie; James Ward; Rebecca Guy; Alice Rumbold; Nathan Ryder; Christopher K Fairley; Basil Donovan; Liz Moore; John Kaldor; Stephen Bell Journal: BMJ Open Date: 2019-05-05 Impact factor: 2.692