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RESEARCH ARTICLE

Chlamydia retesting and retest positivity rates: results from a state-wide laboratory data linkage study in Tasmania, 2012–13

Nicola Stephens A B H , David Coleman C , Kelly Shaw D , Maree O’Sullivan E , Alistair McGregor F , Louise Cooley G and Alison Venn B
+ Author Affiliations
- Author Affiliations

A Communicable Disease Epidemiology and Surveillance, Health Protection Branch, Victorian Department of Health and Human Services, Melbourne, Vic. 3000, Australia.

B Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas. 7000, Australia.

C Public Health Services, Tasmanian Department of Health and Human Services, Hobart, Tas. 7000, Australia.

D Primary Health Tasmania, Hobart, Tas. 7000, Australia.

E Gold Coast Hospital and Health Service, Queensland Health, Gold Coast, Qld 4217, Australia.

F Hobart Pathology, Hobart, Tas. 7000, Australia.

G Royal Hobart Hospital, Hobart, Tas. 7000, Australia.

H Corresponding author. Email: nicola.stephens@dhhs.vic.gov.au

Sexual Health 14(3) 261-267 https://doi.org/10.1071/SH16137
Submitted: 16 July 2016  Accepted: 29 November 2016   Published: 30 January 2017

Abstract

Background: Chlamydia re-infection increases the likelihood of adverse long-term sequelae. Clinical guidelines recommend retesting at 3–12 months for individuals with positive results, to detect re-infections. Retesting and test positivity levels were measured in young people who previously tested positive for chlamydia infection. Methods: All chlamydia tests conducted during 2012–13 in Tasmanian residents aged 15–29 years were linked. Retesting and retest positivity rates were calculated by sex, age, socioeconomic indicators and test timeframe. Results: Retesting rates were higher in females than males at 3 months (14.5%, n = 242/1673 vs 10%, n = 71/721) (P < 0.01) and 12 months (27%, 265/968 vs 24%, 98/410) (P = 0.24). The retesting rate was higher in females living in areas of most disadvantage (35.5%, 154/434) compared with areas of middle and least disadvantage (26% 139/534) (P < 0.01). Males were more likely than females to retest positive at 3 months (35%, 25/71 vs 23%, 55/242) (P < 0.01); retest positivity at 12 months was 32% in both sexes (males 98/140; females 265/968). Retest positivity was higher in males living in areas of least disadvantage (43%, 3/7) compared with middle (24%, 16/67) (P = 0.27) and most (27%, 10/37) (P = 0.09); and higher in females living in areas of least disadvantage (39%, 7/18) compared with middle (24%, 29/121) (P < 0.01) and most (31%, 48/154) (P = 0.02). Conclusions: Retesting rates are low in Tasmania and retest positivity is high, reinforcing the importance of promoting safer sex practices, partner notification and treatment, and retesting.


References

[1]  National Annual Report Writing Group. Australia’s notifiable disease status, 2014: annual report of the National Notifiable Diseases Surveillance System. Commun Dis Intell Q Rep 2016; 40 E48–145. open url image1

[2]  Shaw K, Coleman D, O’Sullivan M, Stephens N. Public health policies and management strategies for genital Chlamydia trachomatis infection. Risk Manag Healthc Policy 2011; 4 57–65.
Public health policies and management strategies for genital Chlamydia trachomatis infection.CrossRef | open url image1

[3]  Hosenfeld CB, Workowski KA, Berman S, Zaidi A, Dyson J, Mosure D, et al Repeat infection with Chlamydia and gonorrhea among females: a systematic review of the literature. Sex Transm Dis 2009; 36 478–89.
Repeat infection with Chlamydia and gonorrhea among females: a systematic review of the literature.CrossRef | open url image1

[4]  Angel G, Horner PJ, O’Brien N, Sharp M, Pye K, Priestley C, et al An observational study to evaluate three pilot programmes of retesting chlamydia-positive individuals within 6 months in the South West of England. BMJ Open 2015; 5 e007455
An observational study to evaluate three pilot programmes of retesting chlamydia-positive individuals within 6 months in the South West of England.CrossRef | open url image1

[5]  Davies B, Ward H, Leung S, Turner KM, Garnett GP, Blanchard JF, et al Heterogeneity in risk of pelvic inflammatory diseases after chlamydia infection: a population-based study in Manitoba, Canada. J Infect Dis 2014; 210 S549–55.
Heterogeneity in risk of pelvic inflammatory diseases after chlamydia infection: a population-based study in Manitoba, Canada.CrossRef | open url image1

[6]  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; 210 S134–55.
Risk of sequelae after Chlamydia trachomatis genital infection in women.CrossRef | open url image1

[7]  Workowski KA, Bolan GA, Centers for Disease Control and Prevention Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64 55–8. open url image1

[8]  Batteiger BE, Tu W, Ofner S, Van Der Pol B, Stothard DR, Orr DP, et al Repeated Chlamydia trachomatis genital infections in adolescent women. J Infect Dis 2010; 201 42–51.
Repeated Chlamydia trachomatis genital infections in adolescent women.CrossRef | open url image1

[9]  The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2015. Available online at: https://kirby.unsw.edu.au/surveillance/2015-annual-surveillance-report-hiv-viral-hepatitis-stis [verified 29 April 2016].

[10]  Fung M, Scott KC, Kent CK, Klausner JD. Chlamydial and gonococcal reinfection among men: a systematic review of data to evaluate the need for retesting. Sex Transm Infect 2007; 83 304–9.
Chlamydial and gonococcal reinfection among men: a systematic review of data to evaluate the need for retesting.CrossRef | open url image1

[11]  Walker J, Tabrizi SN, Fairley CK, Chen MY, Bradshaw CS, Twin J, et al Chlamydia trachomatis incidence and re-infection among young women–behavioural and microbiological characteristics. PLoS One 2012; 7 e37778
Chlamydia trachomatis incidence and re-infection among young women–behavioural and microbiological characteristics.CrossRef | 1:CAS:528:DC%2BC38XotF2htbg%3D&md5=b6ec72a5111b61f45c746bdf6872b475CAS | open url image1

[12]  Bowring AL, Gouillou M, Guy R, Kong FY, 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 | open url image1

[13]  Bowring AL, Goller JL, Gouillou M, Harvey C, Bateson D, McNamee K, et al Chlamydia testing and retesting patterns at family planning clinics in Australia. Sex Health 2013; 10 74–81. open url image1

[14]  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 | open url image1

[15]  The Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice, 8th edition; 2013. Available online at: http://www.racgp.org.au/your-practice/guidelines/redbook/ [verified 18 June 2015].

[16]  Australian Sexual Health Alliance. Australian STI Management Guidelines 2015. Available online at: http://www.sti.guidelines.org.au/sexually-transmissible-infections/chlamydia-follow-up [verified 18 June 2015].

[17]  Geisler WM. Diagnosis and management of uncomplicated Chlamydia trachomatis infections in adolescents and adults: summary of evidence reviewed for the 2015 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines. Clin Infect Dis 2015; 61 S774–84.
Diagnosis and management of uncomplicated Chlamydia trachomatis infections in adolescents and adults: summary of evidence reviewed for the 2015 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines.CrossRef | open url image1

[18]  Smith KS, Hocking JS, Chen MY, Fairley CK, McNulty AM, Read P, et al Dual intervention to increase chlamydia retesting: a randomized controlled trial in three populations. Am J Prev Med 2015; 49 1–11.
Dual intervention to increase chlamydia retesting: a randomized controlled trial in three populations.CrossRef | open url image1

[19]  Australian Bureau of Statistics. Socio-economic indexes for areas 2011. Available online at: http://www.abs.gov.au/ausstats/abs@.nsf/mf/2033.0.55.001 [verified 18 June 2015].

[20]  Tasmania Medicare Local Limited. 2014 Census of Tasmanian general practices. Available online at: http://www.primaryhealthtas.com.au/sites/default/downloads/files/2014%20Census%20of%20Tasmanian%20General%20Practices%20Report.pdf [verified 13 May 2016].

[21]  Australian Government Department of Human Services. Medicare bulk billing 2016. Available online at: https://www.humanservices.gov.au/customer/services/medicare/medicare-bulk-billing [verified 13 May 2016].

[22]  De Abreu Lourenco R, Kenny P, Haas MR, Hall JP. Factors affecting general practitioner charges and Medicare bulk-billing: results of a survey of Australians. Med J Aust 2015; 202 87–90.
Factors affecting general practitioner charges and Medicare bulk-billing: results of a survey of Australians.CrossRef | open url image1

[23]  Australian Institute of Health and Welfare. Australia’s health 2012: the thirteenth biennial health report of the Australian Institute of Health and Welfare 2012. Available online at: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737422169 [verified 29 April 2016].

[24]  Furler JS, Harris E, Chondros P, Powell Davies PG, Harris MF, Young DY. The inverse care law revisited: impact of disadvantaged location on accessing longer GP consultation times. Med J Aust 2002; 177 80–3. open url image1

[25]  Kampman C, Koedijk F, Driessen-Hulshof H, Hautvast J, van den Broek I. Retesting young STI clinic visitors with urogenital Chlamydia trachomatis infection in the Netherlands; response to a text message reminder and reinfection rates: a prospective study with historical controls. Sex Transm Infect 2016; 92 124–9.
Retesting young STI clinic visitors with urogenital Chlamydia trachomatis infection in the Netherlands; response to a text message reminder and reinfection rates: a prospective study with historical controls.CrossRef | open url image1

[26]  Xu F, Stoner BP, Taylor SN, Mena L, Tian LH, Papp J, et al Use of home-obtained vaginal swabs to facilitate rescreening for Chlamydia trachomatis infections: two randomized controlled trials. Obstet Gynecol 2011; 118 231–9.
Use of home-obtained vaginal swabs to facilitate rescreening for Chlamydia trachomatis infections: two randomized controlled trials.CrossRef | open url image1

[27]  Lorch R, Hocking J, Temple-Smith M, Law M, Yeung A, Wood A, et al The chlamydia knowledge, awareness and testing practices of Australian general practitioners and practice nurses: survey findings from the Australian Chlamydia Control Effectiveness Pilot (ACCEPt). BMC Fam Pract 2013; 14 169
The chlamydia knowledge, awareness and testing practices of Australian general practitioners and practice nurses: survey findings from the Australian Chlamydia Control Effectiveness Pilot (ACCEPt).CrossRef | open url image1

[28]  Tasmanian Department of State Growth. Tasmania’s population challenge: 650,000 by 2050, March 2015. Available online at: http://www.stategrowth.tas.gov.au/__data/assets/pdf_file/0017/100376/Background_issues_paper.pdf [verified 9 November 2016].

[29]  Australian Government Department of Health. Notifications of all diseases by State & Territory and year 2015. Available online at: http://www9.health.gov.au/cda/source/rpt_2_sel_a.cfm [verified 17 June 2015].

[30]  Communicable Diseases Network Australia. National blood-borne viruses and sexually transmissible infections surveillance and monitoring plan 2014–2017. Available online at: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-national-strategies [verified 8 May 2016].



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