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RESEARCH ARTICLE

Reattendance and chlamydia retesting rates at 12 months among young people attending Australian general practice clinics 2007–10: a longitudinal study

Emma R. Weaver A J , Anna L. Bowring A , Rebecca Guy B , Caroline van Gemert A C , Jane S. Hocking D , Douglas I. Boyle E , Tony Merritt F , Clare Heal G , Phyllis M. Lau H , Basil Donovan B I , Margaret E. Hellard A C and on behalf of the ACCESS Collaboration
+ Author Affiliations
- Author Affiliations

A Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.

B Kirby Institute, Wallace Wurth Building, UNSW Australia, Sydney, NSW 2052, Australia.

C Department of Epidemiology and Preventative Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Vic. 3004, Australia.

D Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, 207 Bouverie Street, The University of Melbourne, Carlton, Vic. 3010, Australia.

E Health Informatics Unit, Rural Health Academic Centre, 49 Graham Street, Melbourne Medical School, University of Melbourne, Shepparton, Vic. 3630, Australia.

F Hunter New England Population Health, Locked bag 10, Wallsend, NSW 2287, Australia.

G General Practice and Rural Medicine, Mackay Base Hospital, Bridge Road, James Cook University, Mackay, Qld 4740, Australia.

H General Practice and Primary Health Care Academic Centre, 200 Berkeley Street, University of Melbourne, Carlton, Vic. 3053, Australia.

I Sydney Sexual Health Centre, Sydney Hospital, Macquarie Street, Sydney, NSW 2001, Australia.

J Corresponding author. Email: eweaver@burnet.edu.au

Sexual Health 11(4) 366-369 https://doi.org/10.1071/SH14079
Submitted: 30 April 2014  Accepted: 25 May 2014   Published: 24 August 2014

Abstract

Background: Clinical guidelines commonly recommend annual chlamydia (Chlamydia trachomatis) testing in young people. General practice (GP) clinics can play an important role in annual testing, as a high proportion of young people attend these clinics annually; however, little is known about the timing of attendance and testing in this setting. Methods: The Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmitted Infections and Blood-Borne Viruses system extracted consultation and pathology data on 16–29-year-olds attending 25 GP clinics in 2007–10. We calculated the proportion of individuals with an initial negative test that reattended at 12 months (±3 months) and retested at 12 months (±3 months). Individuals with an initial positive test were excluded, as guidelines recommend retesting at 3 months. Results: Among 3852 individuals who had an initial negative test, 2201 (57.1%) reattended at ~12 months; reattendance was higher among females (60.8%) than males (44.1%; P < 0.001) and higher among 16–19-year-olds (64.2%) than 25–29-year-olds (50.8%; P < 0.001). Of 2201 individuals who reattended at 12 months, 377 had a chlamydia test (retesting rate of 9.8%); retesting was higher among females (10.8%) than males (6.1%; P < 0.01) and higher among 16–19-year-olds (13.3%) than 25–29-year-olds (7.5%; P < 0.001). Conclusion: Although over half of young people reattended their GP clinic ~1 year after a negative chlamydia baseline test, only 9.8% were retested at this visit. Strategies are needed to promote regular attendance and testing to both patients and clinicians.

Additional keywords: adolescent, general practitioner, mass screening, young adult.


References

[1]  Department of Health and Ageing (DoHA). Number of notifications of chlamydial infections, Australia, 2012 by age group and sex. National Notifiable Diseases Surveillance System. Canberra: DoHA; 2012.

[2]  Low N. Current status of chlamydia screening in Europe. Eurosurveillance 2004; 8 5

[3]  Haggerty CL, Gottlieb SL, Taylor BD, Low N, Xu F, Ness RB. Risk of sequelae after Chlamydia trachomatis genital infection in women. J Infect Dis 2010; 201 S134–55.
Risk of sequelae after Chlamydia trachomatis genital infection in women.CrossRef | 20470050PubMed |

[4]  Hocking JS, Walker J, Regan D, Chen MY, Fairley CK. Chlamydia screening – Australia should strive to achieve what others have not. Med J Aust 2008; 188 106–8.
| 18205585PubMed |

[5]  Nelson HD, Helfand M. Screening for chlamydial infection. Am J Prev Med 2001; 20 95–107.
Screening for chlamydial infection.CrossRef | 1:STN:280:DC%2BD38%2FgvVaisw%3D%3D&md5=b29235742c96b785d3367863be2def67CAS | 11306238PubMed |

[6]  Regan DG, Wilson DP, Hocking JS. Coverage is the key for effective screening of Chlamydia trachomatis in Australia. J Infect Dis 2008; 198 349–58.
Coverage is the key for effective screening of Chlamydia trachomatis in Australia.CrossRef | 18588484PubMed |

[7]  Shaw K, Stephens N, Coleman D, O’Sullivan M. Role of the general practitioner in testing for genital Chlamydia trachomatis infection: an analysis of enhanced surveillance data. Sex Health 2009; 6 208–12.
Role of the general practitioner in testing for genital Chlamydia trachomatis infection: an analysis of enhanced surveillance data.CrossRef | 19653957PubMed |

[8]  Turner KME, Homer PJ, Trela-Larson L, Sharp M, May M. Chlamydia screening, retesting and repeat diagnoses in Cornwall, UK 2003–2009. Sex Transm Infect 2013; 89 70–5.
Chlamydia screening, retesting and repeat diagnoses in Cornwall, UK 2003–2009.CrossRef |

[9]  US Preventive Services Task Force. Screening for chlamydial infection. Rockville, MD: US Preventive Services Task Force; 2007. Availabe online at: http://www.uspreventiveservicestaskforce.org/uspstf/uspschlm.htm [verified 3 July 2014].

[10]  The Royal Australian College of General Practitioners (RACGP). Guidelines for preventive activities in general practice, 8th edn. Melbourne: RACGP; 2012.

[11]  Bowring AL, Gouillou M, Guy R, Kong FYS, Hocking J, Pirotta M, et al Missed opportunities – low levels of chlamydia retesting at Australian general practices, 2008–2009. Sex Transm Infect 2012; 88 330–4.
Missed opportunities – low levels of chlamydia retesting at Australian general practices, 2008–2009.CrossRef | 22406524PubMed |

[12]  Bowring AL, Gouillou M, Guy R, Kong FYS, van Gemert C, Goller JL et al. Chlamydia repeat testing and positivity rates at general practices and family planning clinics in Australia, 2008–2009. In The Royal Australasian College of Physicians, editors. Proceedings of the 2011 Australasian Sexual Health Conference; 28–30 September 2011; Canberra. Canberra: Australasian Sexual Health Conference; 2011; Abstract no. 468

[13]  Kong FY, Guy RJ, Hocking JS, Merritt T, Pirotta M, Heal C, et al Australian general practitioner chlamydia testing rates among young people. Med J Aust 2011; 194 249–52.
| 21381999PubMed |

[14]  Low N, Forster M, Taylor SN, Nsuami J. Repeat chlamydia screening among adolescents: cohort study in a school-based programme in New Orleans. Sex Transm Infect 2013; 89 20–4.
Repeat chlamydia screening among adolescents: cohort study in a school-based programme in New Orleans.CrossRef | 22773326PubMed |

[15]  Guy RJ, Kong F, Goller J, Franklin N, Bergeri I, Dimech W, et al A new national chlamydia surveillance system in Australia: evaluation of the first stage implementation. Commun Dis Intell Q Rep 2010; 34 319–28.
| 21090187PubMed |

[16]  Sawleshwarkar S, Harrison C, Britt H, Mindel A. Chlamydia testing in general practice in Australia. Sex Health 2010; 7 484–90.
Chlamydia testing in general practice in Australia.CrossRef | 21062591PubMed |

[17]  Kufeji O, Slack R, Cassell JA, Pugh S, Hayward A. Who is being tested for genital chlamydia in primary care? Sex Transm Infect 2003; 79 234–6.
Who is being tested for genital chlamydia in primary care?CrossRef | 1:STN:280:DC%2BD3szhvVCjtA%3D%3D&md5=91f94283fd454a8c32a6bb1614504edeCAS | 12794210PubMed |

[18]  Guy R, Wand H, Franklin N, Fairley CK, Chen MY, O’Connor CC, et al Re-testing for chlamydia at sexual health services in Australia, 2004–08. Sex Health 2011; 8 242–7.
Re-testing for chlamydia at sexual health services in Australia, 2004–08.CrossRef | 21592440PubMed |

[19]  Bayram C, Britt H, Kelly Z, Valenti L. Male consultations in general practice in Australia 1999–00. General practice series no. 11. Canberra: Australian Institute of Health and Welfare; 2003.

[20]  Merritt TD, Durrheim DN, Hope K, Byron P. General practice intervention to increase opportunistic screening for chlamydia. Sex Health 2007; 4 249–51.
General practice intervention to increase opportunistic screening for chlamydia.CrossRef | 18082068PubMed |

[21]  McNulty CA, Freeman E, Bowen J, Shefras J, Fenton KA. Barriers to opportunistic chlamydia testing in primary care. Br J Gen Pract 2004; 54 508–14.
| 15239912PubMed |

[22]  The Royal Australian College of General Practitioners (RACGP). Guidelines for preventive activites in general practice (8th edn). Melbourne: RACGP; 2012.

[23]  McRae I, Yen L, Gillespie J, Douglas K. Patient affiliation with GPs in Australia – who is and who is not and does it matter? Health Policy 2011; 103 16–23.
Patient affiliation with GPs in Australia – who is and who is not and does it matter?CrossRef | 20888058PubMed |



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