Chlamydia among Australian Aboriginal and/or Torres Strait Islander people attending sexual health services, general practices and Aboriginal community controlled health services

James Ward*, Jane Goller, Hammad Ali, Anna Bowring, Sophia Couzos, Mark Saunders, Phyllis Yau, John M. Kaldor, Margaret Hellard, Rebecca J. Guy, Basil Donovan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Background: Chlamydia infections are notified at much higher rates in Aboriginal and/or Torres Strait Islander people compared to non-Indigenous people. The Australian Collaboration Chlamydia Enhanced Sentinel Surveillance System (ACCESS) was established to complement population-based surveillance. Methods. We describe patient demographics, completeness of recording of Aboriginal and/or Torres Strait Islander ('Aboriginal') status, chlamydia testing rates and positivity rates from the Aboriginal Community Controlled Health Service (ACCHSs), General Practice (GP) clinics and Sexual Health Services (SHSs) networks in ACCESS during 2009. Data were extracted from electronic medical records of each participating health service for consultations with patients aged 16-29 years and for chlamydia testing and positivity. Results: Data were included from 16-29 year olds attending six ACCHSs (n = 4,950); 22 SHSs (n = 20,691) and 25 GP clinics (n = 34,462). Aboriginal status was unknown for 79.3% of patients attending GP clinics, 4.5% attending SHSs and 3.8% of patients attending ACCHSs. Chlamydia testing rates among Aboriginal patients were 19.8% (95%CI:18.6%-21.0%) at ACCHSs, 75.5% (95% CI:72.5%-78.4%) at SHSs and 4.3% (95% CI: 2.6%-6.6%) at GP clinics. Positivity rates were highest in Aboriginal patients tested at SHSs at 22.7% (95% CI:19.5%-26.2%), followed by 15.8% (95% CI:3.8%-43.4%) at GP clinics and 8.6% at ACCHSs (95% CI:7.9%-12.4%). This compared with non-Indigenous patients positivity rates at SHSs of 12.7% (95% CI:12.2-13.2%); 8.6% (7.2%-11.3%) at GP clinics and 11.3% at ACCHSs (95% CI:15.4%-24.9%). Conclusions: Higher chlamydia positivity in Aboriginal people across a range of clinical services is reflected in national notification data. Targeted efforts are required to improve testing rates in primary care services; to improve identification of Aboriginal patients in mainstream services such as GP clinics; and to better engage with young Aboriginal Australians.

Original languageEnglish
Article number285
JournalBMC Health Services Research
Volume14
Issue number1
DOIs
Publication statusPublished - 1 Jul 2014
Externally publishedYes

Bibliographical note

Funding Information:
We thank all sentinel sites which provided data for ACCESS. ACCESS is a collaboration between the Kirby Institute, the Burnet Institute, the National Serology Reference Library, the National Perinatal Statistics Unit, and the National Aboriginal Community Controlled Health organization. ACCESS was overseen by a coordinating committee from 2007–2010 which included: Basil Donovan, Rebecca Guy, John Kaldor, James Ward, Hammad Ali - the Kirby Institute, Sydney, NSW; Margaret Hellard, Jane Goller, Fabian Kong, Caroline van Gemert - Burnet Institute, Melbourne, VIC; Elizabeth Sullivan - Perinatal and Reproductive Epidemiology Research Unit, Sydney, NSW; Wayne Dimech - National Serology Reference Laboratory, Fitzroy, VIC. The ACCESS project in 2009 was funded by the Australian Government, Department of Health and Ageing. However the views expressed in this paper are not necessarily the views of the Department of Health and Ageing now known as Department of Health.

Keywords

  • Aboriginal and Torres Strait Islander people
  • Australia
  • Chlamydia
  • Indigenous
  • Positivity
  • Testing

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