Reattendance and chlamydia retesting rates at 12 months among young people attending Australian general practice clinics 2007–10: a longitudinal study

Sexual Health ◽  
2014 ◽  
Vol 11 (4) ◽  
pp. 366 ◽  
Author(s):  
Emma R. Weaver ◽  
Anna L. Bowring ◽  
Rebecca Guy ◽  
Caroline van Gemert ◽  
Jane S. Hocking ◽  
...  
Keyword(s):  
General Practice ◽  
Longitudinal Study ◽  
Chlamydia Trachomatis ◽  
Young People ◽  
Sentinel Surveillance ◽  
Negative Test ◽  
Sexually Transmitted ◽  
Australian General Practice ◽  
Baseline Test ◽  
Pathology Data

Background Clinical guidelines commonly recommend annual chlamydia (Chlamydia trachomatis) testing in young people. General practice (GP) clinics can play an important role in annual testing, as a high proportion of young people attend these clinics annually; however, little is known about the timing of attendance and testing in this setting. Methods: The Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Sexually Transmitted Infections and Blood-Borne Viruses system extracted consultation and pathology data on 16–29-year-olds attending 25 GP clinics in 2007–10. We calculated the proportion of individuals with an initial negative test that reattended at 12 months (±3 months) and retested at 12 months (±3 months). Individuals with an initial positive test were excluded, as guidelines recommend retesting at 3 months. Results: Among 3852 individuals who had an initial negative test, 2201 (57.1%) reattended at ~12 months; reattendance was higher among females (60.8%) than males (44.1%; P < 0.001) and higher among 16–19-year-olds (64.2%) than 25–29-year-olds (50.8%; P < 0.001). Of 2201 individuals who reattended at 12 months, 377 had a chlamydia test (retesting rate of 9.8%); retesting was higher among females (10.8%) than males (6.1%; P < 0.01) and higher among 16–19-year-olds (13.3%) than 25–29-year-olds (7.5%; P < 0.001). Conclusion: Although over half of young people reattended their GP clinic ~1 year after a negative chlamydia baseline test, only 9.8% were retested at this visit. Strategies are needed to promote regular attendance and testing to both patients and clinicians.

scholarly journals Chlamydia incidence in young people in England: results from a widespread screening programme

2004 ◽  
Vol 8 (43) ◽  
Author(s):  
D S LaMontagne ◽  
K. A. Fenton ◽  
Sarah Randall ◽  
S Anderson ◽  
P Carter
Keyword(s):  
Chlamydia Trachomatis ◽  
Young People ◽  
Sexually Transmitted Infection ◽  
Screening Programme ◽  
European Countries ◽  
Transmitted Infection ◽  
Sexually Transmitted

Chlamydia trachomatis is the most frequently reported bacterial sexually transmitted infection (STI) in England, and is also common in many European countries

scholarly journals The relative clinical effectiveness and cost-effectiveness of three contrasting approaches to partner notification for curable sexually transmitted infections: a cluster randomised trial in primary care

2015 ◽  
Vol 19 (5) ◽  
pp. 1-116 ◽  
Author(s):  
Jackie A Cassell ◽  
Julie Dodds ◽  
Claudia Estcourt ◽  
Carrie Llewellyn ◽  
Stefania Lanza ◽  
...  
Keyword(s):  
General Practice ◽  
Young People ◽  
Health Technology Assessment ◽  
Sexually Transmitted Infections ◽  
Technology Assessment ◽  
Partner Notification ◽  
Health Technology ◽  
Web Based ◽  
Sexually Transmitted ◽  
Cluster Randomised

BackgroundPartner notification is the process of providing support for, informing and treating sexual partners of individuals who have been diagnosed with sexually transmitted infections (STIs). It is traditionally undertaken by specialist sexual health services, and may involve informing a partner on a patient’s behalf, with consent. With an increasing proportion of STIs diagnosed in general practice and other community settings, there is a growing need to understand the best way to provide partner notification for people diagnosed with a STI in this setting using a web-based referral system.ObjectiveWe aimed to compare three different approaches to partner notification for people diagnosed with chlamydia within general practice.DesignCluster randomised controlled trial.SettingGeneral practices in England and, within these, patients tested for and diagnosed with genital chlamydia or other bacterial STIs in that setting using a web-based referral system.InterventionsThree different approaches to partner notification: patient referral alone, or the additional offer of either provider referral or contract referral.Main outcome measures(1) Number of main partners per index patient treated for chlamydia and/or gonorrhoea/non-specific urethritis/pelvic inflammatory disease; and (2) proportion of index patients testing negative for the relevant STI at 3 months.ResultsAs testing rates for chlamydia were far lower than expected, we were unable to scale up the trial, which was concluded at pilot stage. We are not able to answer the original research question. We present the results of the work undertaken to improve recruitment to similar studies requiring opportunistic recruitment of young people in general practice. We were unable to standardise provider and contract referral separately; however, we also present results of qualitative work aimed at optimising these interventions.ConclusionsExternal recruitment may be required to facilitate the recruitment of young people to research in general practice, especially in sensitive areas, because of specific barriers experienced by general practice staff. Costs need to be taken into account together with feasibility considerations. Partner notification interventions for bacterial STIs may not be clearly separable into the three categories of patient, provider and contract referral. Future research is needed to operationalise the approaches of provider and contract partner notification if future trials are to provide generalisable information.Trial registrationCurrent Controlled Trials ISRCTN24160819.FundingThis project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 5. See the NIHR Journals Library website for further project information.

scholarly journals Genital Chlamydia trachomatis infections in young adults – a school-based bio-behavioural study in urban areas, Poland, 2012 to 2015

2018 ◽  
Vol 23 (6) ◽  
Author(s):  
Michal Czerwinski ◽  
Marta Niedzwiedzka-Stadnik ◽  
Anna Zielicka-Hardy ◽  
Anna Tomusiak ◽  
Malgorzata Sadkowska-Todys ◽  
...  
Keyword(s):  
Young Adults ◽  
Chlamydia Trachomatis ◽  
Young People ◽  
Urban Areas ◽  
Prevalence Ratio ◽  
Control Programme ◽  
Sexually Transmitted ◽  
Technical Schools ◽  
School Based ◽  
Study Population

Context and Aim One of the most common sexually transmitted pathogens disproportionately affecting young people is Chlamydia trachomatis (CT). This study aimed to assess prevalence of CT among sexually active students (aged 18–19 years) in their final years of high school education in Warsaw and Krakow. Methods: The sample was selected from 61 clusters, each cluster representing one school. We described city, sex, type of school and their association with CT prevalence. To account for non-responders we applied inverse probability weighting. Results: Our study population consisted of 3,136 young adults eligible for CT screening, of whom 2,326 reported having had sexual intercourse within past 12 months. Of the 950 students who agreed to be tested, 39 were infected with CT. Weighted prevalence of CT was 3.9% (95% confidence interval (CI): 2.7–5.1); however, prevalence in the students in Warsaw (6.6%; 95% CI: 3.5–12.4) was six times higher (prevalence ratio (PR) = 5.9; 95% CI: 2.0–17.3) than in Krakow (1.1%; 95% CI: 0.5–2.6). In both settings, female students attending vocational-technical schools were most affected; the prevalence in this group was more than five times higher (PR = 5.2; 95% CI: 1.7–15.6) compared with female peers in high schools and more than three times higher (PR = 3.3; 95% CI: 1.0–10.7) compared with male peers attending vocational-technical schools. Conclusion: Our study suggested prevalence of CT infection among young people in Poland comparable with the European average, supporting implementation of a CT control programme as recommended in international guidelines.

Standards for comprehensive sexual health services for young people under 25 years

2002 ◽  
Vol 13 (6) ◽  
pp. 420-424 ◽  
Author(s):  
K E Rogstad ◽  
I H Ahmed-Jushuf ◽  
A J Robinson
Keyword(s):  
General Practice ◽  
Young People ◽  
Health Service ◽  
Health Services ◽  
Sexual Health ◽  
Sexually Transmitted Infections ◽  
Sexually Transmitted ◽  
Sexual Health Service ◽  
Contraceptive Services ◽  
Level 2

This document is a first response to the need to develop sexual health services for young people on a single site whilst awaiting research from pilot studies of 'one stop shops' suggested in the Sexual Health and HIV strategy. It is a document which is intended to be a tool to use for those wishing to set up a service providing testing for sexually transmitted infections and provision of contraceptive services for those under 25 years. It is not intended that such a service would replace existing specialist or general practice care but complement it, allowing clients to choose the service most appropriate and acceptable to them, with close links and clear pathways of care for referral between services. This paper should be used as a template when initiating and monitoring a clinic but some of the standards may not be achievable without significant financial input. However, economic limitations should not detract from striving to achieve the best possible care for those most at risk from sexually transmitted infections and unwanted pregnancies. For example, not all clinics will be able to provide the recommended tests for the diagnosis for gonorrhoea and chlamydia immediately, but should work towards achieving them. Although the upper age limit in this document is defined as 25 years, some providers may wish to limit clinics to those under 20 depending on local needs. Detailed information on specific issues such as consent and confidentiality, provision of contraception, investigation of non-sexually transmitted vaginal infections and sexually transmitted infection management and diagnosis are referenced and we recommend these are accessed by the users of this document. Many of the references themselves are live documents available on the worldwide web, and are constantly updated. The Sexual Health and HIV Strategy has now been published and these standards are aimed at those who wish to provide a level 2 sexual health service for young people wherever the setting e.g. genitourinary outreach clinic, contraceptive services, general practice. This document is a starting point to be reviewed and updated as new research becomes available, as the Sexual Health Strategy is implemented and with further input from providers of care (family planning, general practice, genitourinary medicine, gynaecology and paediatrics) and service users. All service providers must maintain a high quality of care and have networks both with those who provide more specialized services (Level 3) and Level 1 services. This document is an initial attempt to ensure that there is equity of clinical provision wherever a Level 2 sexual health service is provided and should be a useful tool for those setting up or monitoring services.

Talking to migrant and refugee young people about sexual health in general practice

2018 ◽  
Vol 47 (8) ◽  
pp. 564-569 ◽  
Author(s):  
Jessica R Botfield ◽  
Christy E Newman ◽  
Melissa Kang ◽  
Anthony B Zwi
Keyword(s):  
General Practice ◽  
Young People ◽  
Sexual Health

scholarly journals Mechanisms of Moral Disengagement in the Transition from Cybergossip to Cyberaggression: A Longitudinal Study

2021 ◽  
Vol 18 (3) ◽  
pp. 1000 ◽  
Author(s):  
Daniel Falla ◽  
Rosario Ortega-Ruiz ◽  
Eva M. Romera
Keyword(s):  
Longitudinal Study ◽  
Young People ◽  
Moral Disengagement ◽  
Risky Behaviour ◽  
Online Bullying ◽  
Final Sample ◽  
Longitudinal Association ◽  
Online Behaviour ◽  
Responsible Behaviour ◽  
Fine Distinction

The internet is an area where young people establish relationships and develop socially, emotionally and morally, but it also gives rise to certain forms of online behaviour, such as cybergossip, which are associated with cyberaggression and other risky behaviour. The aims of this study were to verify whether a longitudinal association exists between cybergossip and cyberaggression, and to discover which mechanisms of moral disengagement may mediate this relationship. The final sample consisted of 1392 students (50% girls; Mage = 13.47; SD = 0.77), who were surveyed in a three-wave longitudinal study at six-month intervals. The results obtained confirmed a direct, positive relationship between cybergossip, subsequent cyberaggression and the mediation exerted by cognitive restructuring in this transition. We discuss the importance of recognizing and detecting the fine distinction between online gossip and cyberaggression with the intention of doing harm, and focus on the justifications used by young people to normalize online bullying. To sum up, there is a clear need to encourage ethical, responsible behaviour in online interactions in order to achieve well-balanced, more sustainable relationships in classrooms.

scholarly journals Prevalence of urogenital, anal, and pharyngeal infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium: a cross-sectional study in Reunion island

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Calas ◽  
N. Zemali ◽  
G. Camuset ◽  
J. Jaubert ◽  
R. Manaquin ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Mycoplasma Genitalium ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Urogenital Infection ◽  
High Prevalence

Abstract Background Recommendations for sexually transmitted infection (STI) screening vary significantly across countries. This study evaluated the prevalence of urogenital and extragenital infections with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) in patients visiting a French STI clinic in the Indian Ocean region to determine whether current STI screening practices should be updated. Methods This cross-sectional study examined all patients who visited the STI clinic between 2014 and 2015. Triplex polymerase chain reaction screening for CT, NG, and MG was performed on urine, vaginal, pharyngeal, and anal specimens (FTD Urethritis Basic Kit, Fast Track Diagnostics, Luxembourg). Results Of the 851 patients enrolled in the study, 367 were women (367/851, 43.2%) and 484 were men (484/851, 56.0%). Overall, 826 urogenital specimens (826/851, 97.1%), 606 pharyngeal specimens (606/851, 71.2%), and 127 anal specimens (127/851, 14.9%) were taken from enrolled patients. The prevalence of urogenital CT and MG was high in women ≤25 years (19/186, 10.21%; 5/186, 2.69%) and in men who have sex with women ≤30 years (16/212, 7.54%; 5/212, 2.36%). Among patients with urogenital CT infection, 13.7% (7/51) had urethritis. All patients with urogenital MG infection were asymptomatic. Men who have sex with men had a high prevalence of pharyngeal CT (2/45, 4.44%) and NG (3/44, 6.81%) and a high prevalence of anal CT (2/27, 7.41%), NG (2/27, 7.40%), and MG (1/27, 3.70%). After excluding patients with concomitant urogenital infection, extragenital infections with at least 1 of the 3 pathogens were found in 20 swabs (20/91, 21.9%) taken from 16 patients (16/81, 19.7%), all of them asymptomatic. Conclusions Routine multisite screening for CT, NG, and MG should be performed to mitigate the transmission of STIs in high-risk sexually active populations.

scholarly journals Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Australian General Practice

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.

scholarly journals Study protocol: content and perceived educational utility of different modalities of clinical teaching visit (CTV) workplace-based assessments within Australian general practice vocational training: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045643
Author(s):  
Alison Fielding ◽  
Benjamin Eric Mundy ◽  
Amanda Tapley ◽  
Linda Klein ◽  
Sarah Gani ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Teaching ◽  
Educational Practice ◽  
Cross Sectional Study ◽  
Practice Session ◽  
Cross Sectional ◽  
Human Research Ethics ◽  
General Practice Registrar ◽  
Australian General Practice ◽  
The University

IntroductionClinical teaching visits (CTVs) are formative workplace-based assessments that involve a senior general practitioner (GP) observing a clinical practice session of a general practice registrar (specialist vocational GP trainee). These visits constitute a key part of Australian GP training. Despite being mandatory and resource-intensive, there is a paucity of evidence regarding the content and educational utility of CTVs. This study aims to establish the content and educational utility of CTVs across varying practice settings within Australia, as perceived by registrars and their assessors (‘CT visitors’). In addition, this study aims to establish registrar, CT visitor and practice factors associated with CTV content and perceived CTV utility ratings.Methods and analysisThis study will collect data prospectively using online questionnaires completed soon after incident CTVs. Participants will be registrars and CT visitors of CTVs conducted from March 2020 to January 2021. The setting is three Regional Training Organisations across four Australian states and territories (encompassing 37% of Australian GP registrars).Outcome factors will be a number of specified CTV content elements occurring during the CTV as well as participants’ perceptions of CTV utility, which will be analysed using univariate and multivariable regression.Ethics and disseminationEthics approval has been granted by the University of Newcastle Human Research Ethics Committee, approval number H-2020-0037. Study findings are planned to be disseminated via conference presentation, peer-reviewed journals, educational practice translational workshops and the GP Synergy research subwebsite.

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