An audit of contact tracing for cases of chlamydia in the Australian Capital Territory

Sexual Health ◽  
2005 ◽  
Vol 2 (4) ◽  
pp. 255 ◽  
Author(s):  
Danelle O. England ◽  
Marian J. Currie ◽  
Francis J Bowden
Keyword(s):  
Health Centre ◽  
Contact Tracing ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Australian Capital Territory ◽  
Background Rate ◽  
Sexually Transmitted ◽  
Australian Capital ◽  
Sexual Contacts ◽  
Index Cases

Background: Contact tracing is one of the central pillars of the management of sexually transmitted infections. The aims of this audit were to determine the yield of chlamydia infection from contact tracing the sexual partners of individuals diagnosed with chlamydia and to evaluate and compare the effectiveness of contact tracing undertaken at the Communicable Diseases Control Section (CDCS) of Australian Capital Territory (ACT) Health and the Canberra Sexual Health Centre (the clinic). Methods: A retrospective review of the notification records and contact-tracing documentation was undertaken at CDCS and the clinic from 1 September 2002 to 30 September 2003 (13 months). Results: The background rate of chlamydia in those tested in the ACT community is 3–5%. During the study period, 512 cases of chlamydia were notified to CDCS. Of these, 351 were referred for contact tracing, 293 by CDCS and 98 by the clinic. Of the 437 nominated sexual contacts (average of 1.12 per index case), 272 (62.2%) were contacted, 125 (28.6%) were tested and 51 (11.7%; 95% CI 8.8–15.1) tested positive for chlamydia (15.5%; 95% CI 11.5–20.6% in sexual contacts of CDCS index cases and 7.8%; 95% CI 4.8–12.5% in those of the clinic patients). Contact tracing through the CDCS reached significantly more nominated sexual contacts (78.4% v. 41.7%; P = 0.001) and significantly more of the nominated sexual contacts of index cases reported to CDCS were described as tested (34.7% v. 20.8%; P = 0.01). The average time taken to identify each chlamydia-positive sexual contact was 6.8 hours. Conclusions: Contact tracing more than doubled the case finding effectiveness of chlamydia screening, but was time consuming. These results suggest that provider-initiated contact tracing has clinical and public health value, but that the cost-effectiveness of this approach to chlamydia control should be further evaluated.

Delayed diagnosis of HIV: missed opportunities and triggers for testing in the Australian Capital Territory

Sexual Health ◽  
2006 ◽  
Vol 3 (4) ◽  
pp. 291 ◽  
Author(s):  
Elizabeth A. McDonald ◽  
Marian J. Currie ◽  
Francis J. Bowden
Keyword(s):  
Health Centre ◽  
Delayed Diagnosis ◽  
Significant Risk ◽  
Contact Tracing ◽  
Australian Capital Territory ◽  
Antibody Testing ◽  
Hiv Diagnosis ◽  
Missed Opportunities ◽  
Australian Capital ◽  
Hiv Test

Background: To determine (i) the rate of delayed HIV diagnosis; (ii) the missed opportunities for HIV diagnosis; and (iii) to identify who initiates HIV testing and what triggers them to do so. Methods: An analysis of the case records of all HIV-positive patients who attended Canberra Sexual Health Centre (CSHC) between 1985 and 2005 was conducted. Results: During the study period, 319/355 CSHC patients diagnosed with HIV had sufficient data to allow analysis regarding the timeliness of their diagnosis. Of these, 52 (16.3%) received a delayed diagnosis. The rate of delayed diagnosis was 9.7% (95% CI 5.1–15.3) in the 1980s and 25.6% (95% CI 13–42.1) between 2000 and 2004. There were no statistically significant differences in sociodemographic or behavioural characteristics between patients with delayed and timely HIV diagnoses. To determine who initiated testing, and if there were missed opportunities for testing, the records of CSHC patients diagnosed with HIV between 1995 and 2005 were examined. Of the 115 people diagnosed in this period, only 71 had documentation concerning missed opportunities for testing. Forty-one of these (58%) had been in contact with a health professional while infected, but before their diagnosis of HIV and 39/41 (95%) had a significant risk factor in their history that could have initiated an HIV test. Clinicians initiated testing for 43.5% of the patients, 11.3% were identified through contact tracing and only 28.7% were self referred for testing. Conclusions: Late diagnosis of HIV is common in the Australian Capital Territory and may have increased over time. Clinicians need to be aware of the sometimes-subtle manifestations of early and late HIV infection and have a lower threshold for HIV antibody testing.

scholarly journals Trends in genital chlamydia infection in the Mid-West of Ireland, 2001-2006

2007 ◽  
Vol 12 (10) ◽  
pp. 13-14 ◽  
Author(s):  
D Whyte ◽  
J Powell ◽  
M Horgan ◽  
N O’Connell ◽  
R FitzGerald ◽  
...  
Keyword(s):  
General Practitioners ◽  
Transmitted Disease ◽  
Contact Tracing ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
National Surveillance ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
West Of Ireland

Genital Chlamydia trachomatis (GCT) infection is the most common bacterial sexually transmitted infection (STI) in Ireland. A retrospective analysis of 2,087 laboratory-confirmed GCT patient episodes from 2001 to 2006 in the Mid-West of Ireland was undertaken in conjunction with statutorily notifiable data that were reported by the Sexually Transmitted Disease/Genito-Urinary Medicine (STD/GUM) services in the region and used in national surveillance. Data were analysed by year, source, sex and age. The annual incidence of GCT in the Mid-West is increasing. A substantial proportion of GCT infections were diagnosed in the non-STD/GUM setting. The issue of sexually active young people seeking STI screening is a sensitive one, and delays increase the potential for transmission and the possibility of long-term complications when the disease is not treated. Based on this sample, national surveillance would significantly underestimate the burden of disease in Ireland, due to under-reporting. This would have implications for any national chlamydia screening programme. Among those who sought testing, women aged 15 to 19 years are five times more likely to be found positive than men in the same age group. Of those diagnosed in the non-STD/GUM setting, 83% were women. General practitioners and clinicians might consider targeting those aged 15 to 29 years for opportunistic screening and sexual health advice. Contact tracing and follow-up in the non-STD/GUM setting, as well as access for general practitioners to ongoing education on STIs are challenges to be addressed.

Comparison of the patterns of chlamydia and gonorrhoea at the oropharynx, anorectum and urethra among men who have sex with men

2021 ◽  
pp. sextrans-2020-054632
Author(s):  
Marjan Tabesh ◽  
Christopher K Fairley ◽  
Jane S Hocking ◽  
Deborah A Williamson ◽  
Lei Zhang ◽  
...  
Keyword(s):  
Health Centre ◽  
Single Site ◽  
Chlamydia Infection ◽  
Similar Proportion ◽  
Anatomical Site ◽  
Site Infection ◽  
Site Specific ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
First Time

ObjectiveChlamydia and gonorrhoea are common sexually transmitted infections that infect the oropharynx, anorectum and urethra in men who have sex with men (MSM). This study aimed to examine the pattern of infection at more than one site (multisite) for chlamydia and gonorrhoea among MSM.MethodsThis was a retrospective study of MSM attending the Melbourne Sexual Health Centre for the first time between 2018 and 2019. We included MSM aged ≥16 years who had tested for Neisseria gonorrhoeae and Chlamydia trachomatis at all three sites (oropharynx, anorectum and urethra). We compared infections that occurred at a single site (termed single-site infection) and those that occurred at more than one site (termed multisite infections).ResultsOf the 3938 men who were tested for chlamydia and gonorrhoea, 498/3938 men (12.6%, 95% CI 11.5% to 13.6%) had chlamydia at any site, of whom 400/498 (80.3%, 95% CI 78.9% to 81.2%) had single-site chlamydia infection, and 98/498 (19.7%, 95% CI 16.2% to 23.1%) had multisite infections. A similar proportion of men had gonorrhoea at any site (447/3938, 11.4%, 95% CI 10.3% to 12.2%), but among these 447 men, single-site infection was less common (256/447, 57.3%, 95% CI 52.6% to 61.7%, p<0.001) and multisite infection (191/447, 42.7%, 95% CI 38.2% to 47.3%, p<0.001) was more common than chlamydia. There were also marked differences by anatomical site. Urethral infection commonly occurred as single sites (75/122, 61.5%, 95% CI 52.8% to 70.1%) for chlamydia but uncommonly occurred for gonorrhoea (12/100, 12.0%, 95% CI 5.6% to 18.3%, p<0.001). In contrast, anorectal infection uncommonly occurred as multisite infection for chlamydia (98/394, 24.9%, 95% CI 20.6% to 29.1%) but was common (184/309, 59.5%, 95% CI 54.0% to 64.9%, p<0.001) for gonorrhoea.ConclusionsThe markedly different pattern of site-specific infection for chlamydia and gonorrhoea infections among the same MSM suggests significant differences in the transmissibility between anatomical sites and the duration of each infection at each site.

scholarly journals Men treated for syphilis in Białystok, Poland, 2014-2018

2019 ◽  
pp. 329-335
Author(s):  
Agnieszka Beata Serwin ◽  
Adriana Grochowska ◽  
Iwona Flisiak
Keyword(s):  
Urban Areas ◽  
Partner Notification ◽  
Secondary Syphilis ◽  
Contact Tracing ◽  
Professional Activity ◽  
Symptomatic Infection ◽  
Sexually Transmitted ◽  
Sexual Contacts ◽  
Sex With Men

INTRODUCTION. Incidence of syphilis is increasing in Europe in recent years, mainly due to high incidence in men, especially men who have sex with men (MSM). AIM. To analyse sociodemographic, epidemiological and clinical characteristics of men treated for syphilis in Bialystok in 2014 – 2018, to compare these of MSM and men who have sex with women (MSW). MATERIAL AND METHODS. Analysis of age, residency, professional activity, type of sexual contacts (steady vs. casual), marital status, stage of syphilis diagnosed, concomitant sexually transmitted infections (STIs), treatment, partner notification and follow-up attendance. RESULTS. Of 49 male patients with syphilis 26 (53.06%) were MSM and 23 (46.94%) – MSW. The average age was 33.67 and 35.87 years in MSM and MSW patients, respectively. Majority of patients in both groups were residents of urban areas. Tradesmen and those unemployed constituted the highest proportion in MSM and MSW group, respectively. MSM were in majority single and had only casual contacts while MSW, mostly married or engaged in steady relationship, had also casual contacts. Secondary syphilis was most frequently diagnosed in MSM and late latent syphilis - in MSW. Eight patients (16.32%) had concomitant HIV infection, in all diagnosed before syphilis. Contact tracing was successful in 26.92% of MSM and 39.13% of MSW. Follow-up was not done or not completed in half of MSM and more than half of MSW. CONCLUSIONS. Results confirm that MSM play a crucial role in the current epidemics of syphilis. They have mainly casual sexual contacts and have symptomatic infection. In both MSM and MSW contact tracing and follow-up attendance is suboptimal.

Unusual presentation of a periurethral abscess following infection with Neisseria gonorrhoea

2022 ◽  
Vol 15 (1) ◽  
pp. e246494
Author(s):  
Robin Shepherd ◽  
Alexandra Crossland ◽  
Rafal Turo ◽  
Michelle Christodoulidou
Keyword(s):  
Unusual Case ◽  
Rare Complication ◽  
Health Centre ◽  
Contact Tracing ◽  
Abscess Drainage ◽  
Sexually Transmitted ◽  
Neisseria Gonorrhoea ◽  
Urethral Fistula ◽  
Penile Injury ◽  
Urethral Lesion

We describe an unusual case of a male patient presenting with penile and testicular swelling following an unprotected and traumatic sexual encounter. It was suspected that an isolated penile injury occurred during intercourse; however, ultrasound imaging identified an intact tunical layer and right-sided epididymo-orchitis. Following screening for sexually transmitted infections (STIs), he was discharged with antibiotics and advice to attend the Sexual Health Centre for contact tracing. He represented with a periurethral abscess and an antimicrobial-resistant (AMR) strain of Neisseria gonorrhoea was identified. Appropriate antibiotic treatment was initiated. Examination-under-anaesthesia, following abscess drainage, revealed a contained collection with no urethral fistula; however, a flat urethral lesion was seen during urethroscopy. Repeat urethroscopy and biopsy of the lesion indicated polypoid urethritis. Periurethral abscess secondary to gonococcal urethritis is a rare complication, but one that we should be suspicious of, especially with the growing incidence of AMR-STIs.

Chlamydia Screening Programme, HMP Hydebank Wood Young Offender Centre, Belfast, Northern Ireland, UK

2009 ◽  
Vol 20 (5) ◽  
pp. 360-361 ◽  
Author(s):  
H Hirst ◽  
W W Dinsmore
Keyword(s):  
Northern Ireland ◽  
Sexually Transmitted Diseases ◽  
Screening Programme ◽  
Nucleic Acid Amplification ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Young Offender ◽  
Sexually Transmitted ◽  
High Level ◽  
Male Prisoners

In a young offender's centre, 204 male prisoners were offered chlamydia screening, from January 2007 to April 2007. The aim of this screening programme was to identify and treat asymptomatic prisoners with chlamydia infection. Offering the screening within a prison was an opportunity to test a hard-to-reach population that is at high risk of chlamydia infection. The programme established a high level of testing acceptability with a 98% screening uptake rate. Using nucleic acid amplification testing, 21 (10.5%) tested prisoners were positive for Chlamydia trachomatis. Patients were treated under Patient Group Direction (PGD). Further screening for sexually transmitted diseases was offered to chlamydia-positive patients by the genitourinary (GU) medicine specialist.

Chlamydia screening

2018 ◽  
Vol 11 (7) ◽  
pp. 366-370
Author(s):  
Rabia Aftab
Keyword(s):  
Public Health Problem ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Major Public Health Problem ◽  
Unborn Child ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Genitourinary Medicine ◽  
Sexual Health Clinics

Sexually transmitted infections (STIs) are a major public health problem worldwide, affecting quality of life, adding economic burden and causing serious morbidity. Chlamydia infection is the most common bacterial STI, making up a large proportion of the over 1 000 000 STIs acquired every day. Although easily cured with antibiotics, untreated chlamydial infection can have serious consequences affecting reproductive health and the unborn child. Since chlamydia infection is typically asymptomatic, screening provides an opportunity to prevent complications and reduce transmission. With long waits for genitourinary medicine appointments and busy sexual health clinics, screening in primary care can help to improve chlamydia detection and treatment rates.

Should men with asymptomatic non-specific urethritis be identified and treated?

2008 ◽  
Vol 19 (11) ◽  
pp. 744-746 ◽  
Author(s):  
A Blume ◽  
C Main ◽  
R Patel ◽  
E Foley
Keyword(s):  
Sexually Transmitted Infection ◽  
Significant Proportion ◽  
Contact Tracing ◽  
Retrospective Case ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Contacts ◽  
Health Screen ◽  
Asymptomatic Men ◽  
Case Note Review

There is currently a debate as to whether microscopy is necessary in asymptomatic men presenting for a sexual health screen. Arguments favouring microscopy include finding chlamydia in a significant proportion of sexual partners of men with non-specific urethritis (NSU) in studies that included symptomatic men. We aimed to investigate the proportion of partners of men with asymptomatic NSU who were diagnosed with a sexually transmitted infection. A retrospective case-note review was carried out for all men diagnosed with asymptomatic pathogen-negative NSU, and their traced sexual contacts, during a nine-month period. As a result of contact-tracing, we identified 42 partners who attended the clinic. Only one partner (2.4%) tested positive for chlamydia. A further two partners were diagnosed with a viral sexually transmitted infection (STI). The low level of chlamydia and other STIs in partners of asymptomatic men with pathogen-negative NSU does not support the routine use of microscopy to identify these patients.

Chlamydia Screening

2008 ◽  
Vol 1 (11) ◽  
pp. 737-742 ◽  
Author(s):  
Chantal Simon
Keyword(s):  
Early Detection ◽  
Disease Transmission ◽  
Screening Programme ◽  
Asymptomatic Infection ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Age Group ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
The Uk

Chlamydia is the most common sexually transmitted infection (STI) in the UK. It is asymptomatic in 70% of infected women and 50% of infected men and so often goes undiagnosed. Between 2000 and 2004, the rate of new diagnoses of chlamydia among people who attended Genito-urinary medicine clinics greatly increased from 116 to 175/100 000 ( Fig. 1 ), with the largest increases in chlamydia rates occurring in the under 16 age group. However, the highest rates of chlamydia infection are seen in females aged between 16 and 19 years (1339/100 000) and males aged 20–24 years (1034/100 000). The National Chlamydia Screening Programme (NCSP) in England was established in 2003 with the objective of controlling chlamydia through the early detection and treatment of asymptomatic infection, thus preventing the development of sequelae and reducing onward disease transmission. Similar programmes are underway in the rest of the UK.

scholarly journals Profile of Sexually Transmitted Infections (STIs) among Patients Attending Community Health Centre (CHC), Rangat

2019 ◽  
Vol 08 (01) ◽  
pp. 33-37
Author(s):  
Pradeep B ◽  
Keyword(s):  
Community Health ◽  
Sexually Transmitted Infections ◽  
Health Centre ◽  
Cross Sectional Study ◽  
Community Health Centre ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Sexual Contacts ◽  
Trichomonas Vaginitis

Background: The sexually transmitted infections are common communicable diseases spread through sexual contacts and caused by a broad range of pathogens, e. g., bacteria, chlamydia, virus, fungus, protozoa, ectoparasites, etc. Methods: The study was conducted at Community Health Centre, Rangat, Middle Andaman. This was a cross sectional study involving all the patients attended CHC, Rangat during the period from April, 2017 to October, 2019. The statistical data is expressed as numbers and percentages. Result: 23 patients were diagnosed to have STIs during the study period. Herpes genitalis is the predominant STI diagnosed in 6 patients followed by condyloma acuminata, chancroid, molluscum, trichomonas vaginitis and bacterial vaginosis. Conclusion: Thus, we performed this study to analyse the prevalence of sexually transmitted infection among patients attending CHC, Rangat. This study will be useful for planning and implementation of health care.

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