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Testing for chlamydial infection: Are we meeting clinical guidelines? Evidence from a state-level laboratory data linkage analysis for 15- to 29-year-olds


Stephens, N and Coleman, D and Shaw, K and Sullivan, MO and McGregor, A and Cooley, L and Vally, H and Venn, A, Testing for chlamydial infection: Are we meeting clinical guidelines? Evidence from a state-level laboratory data linkage analysis for 15- to 29-year-olds, Sexual Health, 14, (6) pp. 507-513. ISSN 1449-8987 (2017) [Refereed Article]

Copyright Statement

Copyright 2017 CSIRO

DOI: doi:10.1071/SH16146


Background: Clinical guidelines recommend annual chlamydia tests for all sexually active people aged 15-29 years. This study measured adherence to these guidelines and compared testing rates to the projected levels required to reduce chlamydia prevalence.

Methods: All chlamydia tests conducted in Tasmania during 2012-13, for residents aged 15-29 years, were linked. Data linkage allowed individuals who had multiple tests across different healthcare settings to be counted only once each year in analyses. Rates of testing and test positivity by age, sex, rebate status and socioeconomic indicators were measured.

Results: There were 31899 eligible tests conducted in 24830 individuals. Testing coverage was higher in females (21%, 19404/92685) than males (6%, 5426/98123). Positivity was higher in males (16%, 862/5426) than females (10%, 1854/19404). Most tests (81%, 25803/31899) were eligible for a rebate. Positivity was higher in females with non-rebatable tests (12%, 388/3116 compared with those eligible for a rebate (9%, 1466/16285). More testing occurred in areas of middle disadvantage (10%, 9688/93678) compared with least (8%, 1680/21670) and most (10%, 7284/75460) (both P<0.001) disadvantaged areas. Higher test positivity was found in areas of most-disadvantage (11%, 822/7284) compared with middle- (10%, 983/9688) and least- (8%, 139/1680) disadvantaged areas.

Conclusions: Chlamydia testing rates are lower than recommended levels. Sustaining the current testing rates in females aged 20-24 years may reduce population prevalence within 10 years. This study meets key priorities of national strategies for chlamydia control by providing a method of monitoring testing coverage and evidence to evaluate prevention programs.

Item Details

Item Type:Refereed Article
Keywords:Chlamydia, testing, clinical guidelines, sexual health, Tasmania, testing rates
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Behaviour and health
UTAS Author:Stephens, N (Dr Nicola Stephens)
UTAS Author:Venn, A (Professor Alison Venn)
ID Code:124259
Year Published:2017
Web of Science® Times Cited:2
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-02-15
Last Modified:2019-05-21

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