Register      Login
Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

Contact tracing for sexually transmitted infections in Aotearoa New Zealand: a review of clinician-notified gonorrhoea and syphilis data

Catriona Murray 1 * , Sally B. Rose https://orcid.org/0000-0002-5626-5142 2 , Amanda Kvalsvig 1 , Michael G. Baker 1
+ Author Affiliations
- Author Affiliations

1 Department of Public Health, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand.

2 Department of Primary Health Care and General Practice, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand.

* Correspondence to: catriona144@gmail.com

Handling Editor: Tim Stokes

Journal of Primary Health Care 15(2) 167-171 https://doi.org/10.1071/HC22147
Published: 17 January 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction: The sexually transmitted infections (STIs) gonorrhoea and syphilis became notifiable in Aotearoa New Zealand in 2017, requiring diagnosing clinicians to complete an anonymous case report form detailing behavioural, clinical and management information. Surveillance for gonorrhoea occurs through laboratory and clinician notification, whereas syphilis is only clinician-notified.

Aim: To review information related to contact tracing (partner notification) from routinely collected gonorrhoea and syphilis notification data.

Methods: Aggregated data on clinician-notified gonorrhoea and syphilis cases in 2019 were analysed to review information related to contact tracing and to estimate numbers of partners requiring contact tracing.

Results: There were 722 cases of syphilis and 3138 cases of gonorrhoea notified by clinicians in 2019. However, there were 7200 laboratory-notified gonorrhoea cases, so clinician notification occurred for less than half (43.6%, 3138/7200) of the cases, ranging from 10.0 to 61.5% across District Health Board regions. An estimated 28 080 recent contacts of gonorrhoea cases and 2744 contacts of syphilis cases would have required contact tracing in 2019. Contact tracing could not be completed for 20% of syphilis and 16% of gonorrhoea cases due to anonymous contacts, and was ‘initiated or planned’ for 81% of gonorrhoea cases and 79% of syphilis cases.

Discussion: Although surveillance data for gonorrhoea and syphilis are incomplete, estimates can be obtained about the number and type of contacts, which can be used to inform contact tracing strategies. Optimisation of the content of clinician-completed forms and an improved response rate would provide a more complete picture to inform interventions to address the high and inequitable prevalence of sexually transmitted infections in Aotearoa New Zealand.

Keywords: contact tracing, gonorrhoea, New Zealand, partner notification, primary care, sexually transmitted infections, surveillance, syphilis.


References

[1]  New Zealand Sexual Health Society. STI management guidelines for use in primary care. Partner notification and contact tracing. 2021. Available at https://sti.guidelines.org.nz/wp-content/uploads/2021/10/Partner-Notification-final-Sept-2021-v2.pdf [Accessed 15 November 2022].

[2]  Ward H, Bell G. Partner notification. Medicine 2014; 42 314–7.
Partner notification.Crossref | GoogleScholarGoogle Scholar |

[3]  European Centre for Disease Prevention and Control (ECDC). Public health benefits of partner notification for sexually transmitted infections and HIV. Technical report. Stockholm: ECDC; 2013. Available at http://www.ecdc.europa.eu/en/publications/Publications/Partner-notification-for-HIV-STI-June-2013.pdf [Accessed 12 December 2022].

[4]  Rose SB, Garrett SM, Kennedy J, et al. Partner notification and retesting for Chlamydia trachomatis and Neisseria gonorrhoeae: a case-note review in New Zealand primary care. J Prim Health Care 2018; 10 132–9.
Partner notification and retesting for Chlamydia trachomatis and Neisseria gonorrhoeae: a case-note review in New Zealand primary care.Crossref | GoogleScholarGoogle Scholar |

[5]  Rose SB, Garrett SM, Pullon SRH. Overcoming challenges associated with partner notification following chlamydia and gonorrhoea diagnosis in primary care: a postal survey of doctors and nurses. J Prim Health Care 2017; 9 136–44.
Overcoming challenges associated with partner notification following chlamydia and gonorrhoea diagnosis in primary care: a postal survey of doctors and nurses.Crossref | GoogleScholarGoogle Scholar |

[6]  Azariah S. An audit of patients treated for syphilis at Auckland Sexual Health Service. N Z Med J 2010; 123 55–64. Available at http://www.nzma.org.nz/journal/123-1315/4127/

[7]  Rose SB, Garrett SM, Pullon SRH. Improving management of sexually transmitted infections in primary care: feasibility and acceptability of a new patient management tool for clinicians. J Prim Health Care 2021; 13 171–9.
Improving management of sexually transmitted infections in primary care: feasibility and acceptability of a new patient management tool for clinicians.Crossref | GoogleScholarGoogle Scholar |

[8]  Rose SB, Garrett SM, Hutchings D, et al. Addressing gaps in the management of Chlamydia trachomatis and Neisseria gonorrhoeae in primary care: lessons learned in a pilot intervention study. Sex Transm Dis 2019; 46 480–6.
Addressing gaps in the management of Chlamydia trachomatis and Neisseria gonorrhoeae in primary care: lessons learned in a pilot intervention study.Crossref | GoogleScholarGoogle Scholar |

[9]  Coughlan E, Young H, Parkes C, et al. A novel response to an outbreak of infectious syphilis in Christchurch, New Zealand. Sex Health 2015; 12 170–3.
A novel response to an outbreak of infectious syphilis in Christchurch, New Zealand.Crossref | GoogleScholarGoogle Scholar |

[10]  Azariah S, McKernon S, Werder S. Large increase in opportunistic testing for chlamydia during a pilot project in a primary health organisation. J Prim Health Care 2013; 5 141–5.
Large increase in opportunistic testing for chlamydia during a pilot project in a primary health organisation.Crossref | GoogleScholarGoogle Scholar |

[11]  McKernon S, Azariah S. Staff views of an opportunistic chlamydia testing pilot in a primary health organisation. J Prim Health Care 2013; 5 283–9.
Staff views of an opportunistic chlamydia testing pilot in a primary health organisation.Crossref | GoogleScholarGoogle Scholar |

[12]  Steen R, Wi TE, Kamali A, et al. Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm. Bull World Health Organ 2009; 87 858–65.
Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm.Crossref | GoogleScholarGoogle Scholar |

[13]  German RR, Lee LM, Horan JM, et al. Updated guidelines for evaluating public health surveillance systems. Recommendations from the Guidelines Working Group. MMWR Recomm Rep 2001; 50 1–35. Available at https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5013a1.htm [Accessed 15 November 2022].

[14]  New Zealand Parliament. Health (Protection) Amendment Act 2016, Section C—Infectious diseases notifiable to medical officer of health without identifying information of patient or deceased person. 2016. Available at https://www.legislation.govt.nz/act/public/2016/0035/latest/DLM6223006.html [Accessed 15 November 2022].

[15]  The Institute of Environmental Science and Research Limited. Surveillance of sexually transmitted infections. Notifications. Porirua, New Zealand; 2022. Available at https://surv.esr.cri.nz/public_health_surveillance/sti_surveillance.php [Accessed 15 November 2022].

[16]  The Institute of Environmental Science and Research Ltd. New Zealand Sexually Transmitted Infection (STI) Surveillance Dashboard. 2022. Available at https://www.esr.cri.nz/our-services/consultancy/public-health/sti/ [Accessed 15 November 2022].

[17]  The Institute of Environmental Science and Research Limited. Sexually Transmitted Infections in New Zealand: Supplementary Annual Surveillance Report 2020. Porirua, New Zealand; 2022. Available at https://surv.esr.cri.nz/PDF_surveillance/STISurvRpt/2020/FINAL_STI_supplementaryreport_2020.pdf [Accessed 15 November 2022].

[18]  The Institute of Environmental Science and Research Ltd. Sexually Transmitted Infections in New Zealand: Supplementary Annual Surveillance Report 2021. Porirua, New Zealand; 2022. Available at https://surv.esr.cri.nz/PDF_surveillance/STISurvRpt/2021/FINAL_STI_supplementaryreport_2021.pdf [Accessed 9 December 2022].

[19]  Wallis KA, Saxton PJ. Gonorrhoea: the pain and shame of notification. J Prim Health Care 2019; 11 195–206.
Gonorrhoea: the pain and shame of notification.Crossref | GoogleScholarGoogle Scholar |

[20]  Wayal S, Estcourt CS, Mercer CH, et al. Optimising partner notification outcomes for bacterial sexually transmitted infections: a deliberative process and consensus, United Kingdom, 2019. Euro Surveill 2022; 27 2001895
Optimising partner notification outcomes for bacterial sexually transmitted infections: a deliberative process and consensus, United Kingdom, 2019.Crossref | GoogleScholarGoogle Scholar |