scholarly journals COVID-19 Demographics, Acute Care Resource Use and Mortality by Age and Sex in Ontario, Canada: Population-based Retrospective Cohort Analysis

2020 ◽  
Author(s):  
Stephen Mac ◽  
Kali Barrett ◽  
Yasin A. Khan ◽  
David MJ Naimark ◽  
Laura Rosella ◽  
...  
Keyword(s):  
Acute Care ◽  
Resource Use ◽  
Cohort Analysis ◽  
Invasive Mechanical Ventilation ◽  
Temporal Trends ◽  
Age Groups ◽  
Population Based ◽  
Term Care ◽  
Over Time ◽  
Age And Sex

AbstractBackgroundUnderstanding resource use for COVID-19 is critical. We conducted a population-based cohort study using public health data to describe COVID-19 associated age- and sex-specific acute care use, length of stay (LOS), and mortality.MethodsWe used Ontario’s Case and Contact Management (CCM) Plus database of individuals who tested positive for COVID-19 in Ontario from March 1 to September 30, 2020 to determine age- and sex-specific hospitalizations, intensive care unit (ICU) admissions, invasive mechanical ventilation (IMV) use, LOS, and mortality. We stratified analyses by month of infection to study temporal trends and conducted subgroup analyses by long-term care residency.ResultsDuring the observation period, 56,476 COVID-19 cases were reported (72% < 60 years, 52% female). The proportion of cases shifted from older populations (> 60 years) to younger populations (10-39 years) over time. Overall, 10% of individuals were hospitalized, of those 22% were admitted to ICU, and 60% of those used IMV. Mean LOS for individuals in the ward, ICU without IMV, and ICU with IMV was 12.8, 8.5, 20.5 days, respectively. Mortality for individuals receiving care in the ward, ICU without IMV, and ICU with IMV was 24%, 30%, and 45%, respectively. All outcomes varied by age and decreased over time, overall and within age groups.InterpretationThis descriptive study shows acute care use and mortality varying by age, and decreasing between March and September in Ontario. Improvements in clinical practice and changing risk distributions among those infected may contribute to fewer severe outcomes among those infected with COVID-19.

Abstract WMP94: Temporal Trends in Racial, Age, and Sex-Specific Utilization of Decompressive Hemicraniectomy Among Acute Ischemic Stroke Patients in the United States

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Sai P Polineni ◽  
Fadar O Otite ◽  
Seemant Chaturvedi
Keyword(s):  
United States ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Temporal Trends ◽  
Age Groups ◽  
The United States ◽  
Decompressive Hemicraniectomy ◽  
Study Results ◽  
Over Time ◽  
Age And Sex

Background: The aim of this study is to evaluate current trends in racial, age, and sex-specific utilization of decompressive hemicraniectomy (HC) in acute ischemic stroke (AIS) patients in the United States over the last decade. Methods: All adult patients with a diagnosis of AIS were identified from the 2004-2015 Nationwide Inpatient Sample (weighted N=4,792,428) using International Classification of Diseases Ninth revision (ICD-9) codes. Proportion of patients undergoing HC in various age, race, and sex groups were ascertained using ICD-9 procedural codes. Temporal trends were mapped by year in order to track changes in utilization over time. Analysis of utilization disparities and trends within age, sex, and race subgroups was conducted via multivariate logistic regression. Results: Of all eligible AIS patients from 2004-2015, 0.25% underwent HC (.08 in 2004 to .46 in 2015). Increased utilization over time was seen in both men (.13 to .57) and women (.08 to .54), with women showing comparable odds of utilization to men [OR: 0.95 (95% CI: .87-1.04, p=0.27)]. Similarly, increased utilization trends were seen in all age groups (Figure 1) with the highest rates in the 18-39 subgroup (1.41%). Compared to trends in this younger subgroup (.43 to 2.12), patients aged 60-79 experienced a similar overall increase but at lower utilization rates (.06 to .37). Compared to white patients in multivariate models, blacks did not show significant differences in odds of HC [1.09 (.96-1.24, p=0.20)], while patients from Hispanic [1.25 (1.03-1.51, p=0.02)] and other [1.26 (1.04-1.52, p=0.02)] race-ethnic groups showed increased odds. Conclusions: From 2004-2015, hemicraniectomy rates have seen substantial increases in all age, sex, and race groups. The increasing rates of hemicraniectomies among those over age 60 suggest that there has been at least partial acceptance of DESTINY 2 study results.

scholarly journals Temporal trends in use of tests in UK primary care, 2000-15: retrospective analysis of 250 million tests

BMJ ◽  
2018 ◽  
pp. k4666 ◽  
Author(s):  
Jack W O’Sullivan ◽  
Sarah Stevens ◽  
F D Richard Hobbs ◽  
Chris Salisbury ◽  
Paul Little ◽  
...  
Keyword(s):  
Primary Care ◽  
Temporal Trends ◽  
Age Groups ◽  
Fold Increase ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Test Use ◽  
Over Time ◽  
Age And Sex ◽  
Total Test

Abstract Objectives To assess the temporal change in test use in UK primary care and to identify tests with the greatest increase in use. Design Retrospective cohort study. Setting UK primary care. Participants All patients registered to UK General Practices in the Clinical Practice Research Datalink, 2000/1 to 2015/16. Main outcome measures Temporal trends in test use, and crude and age and sex standardised rates of total test use and of 44 specific tests. Results 262 974 099 tests were analysed over 71 436 331 person years. Age and sex adjusted use increased by 8.5% annually (95% confidence interval 7.6% to 9.4%); from 14 869 tests per 10 000 person years in 2000/1 to 49 267 in 2015/16, a 3.3-fold increase. Patients in 2015/16 had on average five tests per year, compared with 1.5 in 2000/1. Test use also increased statistically significantly across all age groups, in both sexes, across all test types (laboratory, imaging, and miscellaneous), and 40 of the 44 tests that were studied specifically. Conclusion Total test use has increased markedly over time, in both sexes, and across all age groups, test types (laboratory, imaging, and miscellaneous) and for 40 of 44 tests specifically studied. Of the patients who underwent at least one test annually, the proportion who had more than one test increased significantly over time.

scholarly journals Using Administrative Data to Incorporate Age and Sex-Dependent Resource Use for COVID-19 Acute Care Resource Use Simulations in Ontario, Canada

2020 ◽  
Author(s):  
Stephen Mac ◽  
Raphael Ximenes ◽  
Kali Barrett ◽  
Yasin A. Khan ◽  
Petros Pechlivanoglou ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Care ◽  
Resource Use ◽  
Regional Analysis ◽  
Age Groups ◽  
Time Dependent ◽  
Care Planning ◽  
Local Data ◽  
Care Level ◽  
Age And Sex

AbstractAs the COVID-19 pandemic has progressed, more local data has become available, enabling a more granular modeling approach. In March 2020, we developed a COVID-19 Resource Estimator (CORE) model to estimate the acute care resource use in Ontario, Canada. In this paper, we describe the evolution of CORE2.0 to incorporate age, sex, and time-dependent acute care resource use, length of stay, and mortality to simulate hospital occupancy. Demographics (e.g., age and sex) of infected cases are informed by 4-month averages between March-June, and July-October using 10-year age groups. The probability of hospitalization, ICU admission, and requiring mechanical ventilation are all age and sex-dependent. LOS for each acute care level ranges from 5.7 to 16.15 days in the ward, 6.5 to 10.7 days in the ICU without ventilation, and 14.8 to 21.6 days on the ventilator, depending on month of infection. We calibrated some LOS components to reported ward and ICU occupancy between June 15 and October 31, 2020. Furthermore, we demonstrate the use of CORE2.0 for a regional analysis of Region of Waterloo, Ontario, Canada to simulate the ward bed, ICU bed, and ventilator occupancies for 30 days starting December 2020 for three case trajectory scenarios. Moving forward, this model has become highly flexible and customizable to data updates, and can better inform acute care planning and public measures as the pandemic progresses.

scholarly journals 224. Evaluating the Epidemiology of Bloodstream Infections: A Population-Based Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S219-S220
Author(s):  
Elaha Niazi ◽  
Kwadwo Mponponsuo ◽  
Ranjani Somayaji ◽  
Elissa Rennert-May ◽  
John Conly ◽  
...  
Keyword(s):  
Large Population ◽  
Age Groups ◽  
Bloodstream Infections ◽  
Population Based ◽  
Incidence Rates ◽  
Population Based Study ◽  
Health Region ◽  
Canadian Health ◽  
Over Time ◽  
Age And Sex

Abstract Background Bloodstream infections (BSI) are a major cause of morbidity, mortality, and health care costs worldwide. Population-based studies are key to assess BSI epidemiology over time while minimizing selection bias but remain limited. Therefore, we aimed to assess the incidence of BSI in a large Canadian health region in a contemporary period. We hypothesized that there would be significant age and sex-based differences including over time. Methods We conducted a retrospective cohort study from 2011 through 2018 using a population-based microbiology database to determine the annual age- and sex-specific BSI testing and case rates with the census as the population reference. BSI was defined as a positive blood culture for a pathogen. Episodes &gt; 30 days apart were included for analysis. Incidence rate ratios (IRR) for testing and case rates including by sex were calculated to assess changes over time. All analyses were run at a two-sided α of 0.05 and were conducted with R 4.0.4. Results A total of 154,147 distinct individuals (49.9% male) were analyzed and 22,869 (14.8%) had a BSI at the first encounter in the study period. Overall BSI testing incidence ranged from 1529 to 1707 per 100,000 person-years and case incidence ranged from 180 to 292 per 100,000 person-years. Testing and case incidence for BSI was greatest in the 0-4 and 75+ years age groups (p &lt; 0.01). Males compared to females had greater testing and case incidence rates in young and old age groups, but females had greater rates in the 15-44 years groups (p &lt; 0.01). Overall IRR for cases comparing 2018 to 2011 was 0.62 (95% CI 0.59-0.65) reflecting a significant decrease over time. Testing also decreased over the study period with an IRR of 0.90 (95% CI 0.88-0.91). Testing and case IRRs were not significantly different stratified by sex. Incidence rates (per 100,000 person-years) of BSI testing and cases by sex from 2011 through 2018 in a Canadian health region Conclusion In our large population-based study of BSI, we identified that BSI remain frequent and the youngest and oldest age groups as well as males in these age groups have the greatest BSI incidence rates which may reflect both biological sex and gender-based differences. Encouragingly, BSI incidence rates have decreased over time at a greater increment relative to testing rates. Future studies of BSI should focus on pathogen and outcome-based evaluations. Disclosures All Authors: No reported disclosures

scholarly journals Acute healthcare resource utilization by age: A cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251877
Author(s):  
Bourke W. Tillmann ◽  
Longdi Fu ◽  
Andrea D. Hill ◽  
Damon C. Scales ◽  
Robert A. Fowler ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Age Groups ◽  
Population Based ◽  
Healthcare Resource Utilization ◽  
Icu Admission ◽  
Care Services ◽  
Ed Visits ◽  
Acute Healthcare ◽  
Over Time

Background Granular data related to the likelihood of individuals of different ages accessing acute and critical care services over time is lacking. Methods We used population-based, administrative data from Ontario to identify residents of specific ages (20, 30, 40, etc. to 100) on January 1st every year from 1995–2019. We assessed rates of emergency department (ED) visits (2003–19), hospitalizations, intensive care unit (ICU) admissions (2003–19), and mechanical ventilation. Findings Overall the 25-year study period, ED were the most common acute healthcare encounter with 100-year-olds having the lowest rate (138.7/1,000) and 90-year-olds the highest (378.5/1,000). Rates of hospitalization ranged from 24.2/1,000 for those age 20 up to 224.9/1,000 for those age 90. Rates of ICU admission and mechanical ventilation were lowest for those age 20 (1.0 and 0.4/1,000), more than tripled by age 50 (3.3 and 1.7/1,000) and peaked at age 80 (20.3 and 10.1/1,000). Over time rates of ED visits increased (164.3 /1,000 in 2003 vs 199.1 /1,000 in 2019) as did rates of invasive mechanical ventilation (2.0/1,000 in 1995 vs 2.9/1,000 in 2019), whereas rates of ICU admission remained stable (4.8/1,000 in 2003 vs 4.9/1,000 in 2019) and hospitalization declined (66.8/1,000 in 1995 vs 51.5/1,000 in 2019). Age stratified analysis demonstrated that rates of ED presentation increased for those age 70 and younger while hospitalization decreased for all age groups; ICU admission and mechanical ventilation rates changed variably by age, with increasing rates demonstrated primarily among people under the age of 50. Interpretation Rates of hospitalizations have decreased over time across all age groups, whereas rates of ED presentation, ICU admissions, and mechanical ventilation have increased, primarily driven by younger adults. These findings suggest that although the delivery of healthcare may be moving away from inpatient medicine, there is a growing population of young adults requiring significant healthcare resources.

scholarly journals OP0248 PREMATURE MORTALITY BURDEN FOR SYSTEMIC SCLEROSIS: NATIONWIDE POPULATION-BASED STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 156.1-156
Author(s):  
E. Yen ◽  
D. Singh ◽  
M. Wu ◽  
R. Singh
Keyword(s):  
Rheumatoid Arthritis ◽  
United States ◽  
Disease Burden ◽  
Age Groups ◽  
Premature Mortality ◽  
Population Based ◽  
Age Group ◽  
Population Based Study ◽  
Mortality Burden ◽  
Over Time

Background:Premature mortality is an important way to quantify disease burden. Patients with systemic sclerosis (SSc) can die prematurely of disease, however, the premature mortality burden of SSc is unknown. The years of potential life lost (YPLL), in addition to age-standardized mortality rate (ASMR) in younger ages, can be used as measures of premature death.Objectives:To evaluate the premature mortality burden of SSc by calculating: 1) the proportions of SSc deaths as compared to deaths from all other causes (non-SSc) by age groups over time, 2) ASMR for SSc relative to non-SSc-ASMR by age groups over time, and 3) the YPLL for SSc relative to other autoimmune diseases.Methods:This is a population-based study using a national mortality database of all United States residents from 1968 through 2015, with SSc recorded as the underlying cause of death in 46,798 deaths. First, we calculated the proportions of deaths for SSc and non-SSc by age groups for each of 48 years and performed joinpoint regression trend analysis1to estimate annual percent change (APC) and average APC (AAPC) in the proportion of deaths by age. Second, we calculated ASMR for SSc and non-SSc causes and ratio of SSc-ASMR to non-SSc-ASMR by age groups for each of 48 years, and performed joinpoint analysis to estimate APC and AAPC for these measures (SSc-ASMR, non-SSc-ASMR, and SSc-ASMR/non-SSc-ASMR ratio) by age. Third, to calculate YPLL, each decedent’s age at death from a specific disease was subtracted from an arbitrary age limit of 75 years for years 2000 to 2015. The years of life lost were then added together to yield the total YPLL for each of 13 preselected autoimmune diseases.Results:23.4% of all SSc deaths as compared to 13.5% of non-SSc deaths occurred at <45 years age in 1968 (p<0.001, Chi-square test). In this age group, the proportion of annual deaths decreased more for SSc than for non-SSc causes: from 23.4% in 1968 to 5.7% in 2015 at an AAPC of -2.2% (95% CI, -2.4% to -2.0%) for SSc, and from 13.5% to 6.9% at an AAPC of -1.5% (95% CI, -1.9% to -1.1%) for non-SSc. Thus, in 2015, the proportion of SSc and non-SSc deaths at <45 year age was no longer significantly different. Consistently, SSc-ASMR decreased from 1.0 (95% CI, 0.8 to 1.2) in 1968 to 0.4 (95% CI, 0.3 to 0.5) per million persons in 2015, a cumulative decrease of 60% at an AAPC of -1.9% (95% CI, -2.5% to -1.2%) in <45 years old. The ratio of SSc-ASMR to non-SSc-ASMR also decreased in this age group (cumulative -20%, AAPC -0.3%). In <45 years old, the YPLL for SSc was 65.2 thousand years as compared to 43.2 thousand years for rheumatoid arthritis, 18.1 thousand years for dermatomyositis,146.8 thousand years for myocarditis, and 241 thousand years for type 1 diabetes.Conclusion:Mortality at younger ages (<45 years) has decreased at a higher pace for SSc than from all other causes in the United States over a 48-year period. However, SSc accounted for more years of potential life lost than rheumatoid arthritis and dermatomyositis combined. These data warrant further studies on SSc disease burden, which can be used to develop and prioritize public health programs, assess performance of changes in treatment, identify high-risk populations, and set research priorities and funding.References:[1]Yen EY….Singh RR. Ann Int Med 2017;167:777-785.Disclosure of Interests:None declared

Abstract P372: Coronary Angiography Use, Results and Revascularization Trends in Olmsted County, Minnesota, 2000 to 2015

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Yariv L Gerber ◽  
Susan Weston ◽  
Jill Killian ◽  
Matteo Fabbri ◽  
Sheila Manemann ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Regression Models ◽  
Direct Method ◽  
Coronary Revascularization ◽  
Temporal Trends ◽  
Olmsted County ◽  
Left Main ◽  
Logistic Regression Models ◽  
Over Time ◽  
Age And Sex

Background: A decline in all forms of coronary revascularization has been previously reported. Whether the decline has continued after the turn of the century is unknown as well as whether it is influenced by trends in the use and results of coronary angiography. Methods: All diagnostic and therapeutic coronary procedures performed among Olmsted County, MN residents from 2000-2015 were analyzed. Standardized rates (per 100,000 population) were calculated applying the direct method and temporal trends compared using Poisson regression models. Trends in disease severity, defined as 3-vessel and/or left main coronary artery disease (CAD), were assessed using logistic regression models. Results: Between 2000 and 2015, 11,691 coronary angiographies were performed (63% men; 54% ≥ 65 years of age). The age- and sex-standardized rates of angiography decreased over time (p trend < 0.001; Figure). Overall, 30% of the subjects had 3-vessel and/or left main CAD, and this proportion decreased over time (age- and sex-adjusted odds ratios (95% CI) for severe CAD: 0.68 (0.62-0.76) in 2005-2009 and 0.69 (0.63-0.77) in 2010-2015 compared with 2000-2004). Among 5,222 coronary revascularization procedures performed, 78% were PCI and 22% CABG. The age- and sex-standardized rates of any revascularization declined during the study period, reflecting temporal decreases in both PCI and CABG (all p trend < 0.001; Figure). The declines in angiography rates, CAD severity, and revascularization utilization were consistently greater in women than men (all P for interactions < 0.01). Conclusions: Declines in all forms of coronary revascularization, which were greater in women than men, have occurred in Olmsted County, MN, from 2000-2015. The declines occurred in the context of fewer angiograms performed in the population and reduced severity of anatomic CAD.

scholarly journals Existing comorbidities in people with osteoarthritis: a retrospective analysis of a population-based cohort in Alberta, Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033334 ◽  
Author(s):  
Deborah A Marshall ◽  
Xiaoxiao Liu ◽  
Cheryl Barnabe ◽  
Karen Yee ◽  
Peter D Faris ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Age Groups ◽  
Population Based ◽  
Case Definition ◽  
Chronic Obstructive ◽  
Age Group ◽  
Case Definitions ◽  
Obstructive Pulmonary Disease ◽  
Physician Visits ◽  
Significant Difference

ObjectivesThe purpose of this study is to estimate the prevalence of comorbidities among people with osteoarthritis (OA) using administrative health data.DesignRetrospective cohort analysis.SettingAll residents in the province of Alberta, Canada registered with the Alberta Health Care Insurance Plan population registry.Participants497 362 people with OA as defined by ‘having at least one OA-related hospitalization, or at least two OA-related physician visits or two ambulatory care visits within two years’.Primary outcome measuresWe selected eight comorbidities based on literature review, clinical consultation and the availability of validated case definitions to estimate their frequencies at the time of diagnosis of OA. Sex-stratified age-standardised prevalence rates per 1000 population of eight clinically relevant comorbidities were calculated using direct standardisation with 95% CIs. We applied χ2 tests of independence with a Bonferroni correction to compare the percentage of comorbid conditions in each age group.Results54.6% (n=2 71 794) of people meeting the OA case definition had at least one of the eight selected comorbidities. Females had a significantly higher rate of comorbidities compared with males (standardised rates ratio=1.26, 95% CI 1.25 to 1.28). Depression, chronic obstructive pulmonary disease (COPD) and hypertension were the most prevalent in both females and males after age-standardisation, with 40% of all cases having any combination of these comorbidities. We observed a significant difference in the percentage of comorbidities among age groups, illustrated by the youngest age group (<45 years) having the highest percentage of cases with depression (24.6%), compared with a frequency of 16.1% in those >65 years.ConclusionsOur findings highlight the high frequency of comorbidity in people with OA, with depression having the highest age-standardised prevalence rate. Comorbidities differentially affect females, and vary by age. These factors should inform healthcare programme and delivery.

scholarly journals Temporal Trends in Surgical Resection Rates and Biologic Prescribing in Crohn’s Disease: A Population-based Cohort Study

2020 ◽  
Vol 14 (9) ◽  
pp. 1241-1247
Author(s):  
P W Jenkinson ◽  
N Plevris ◽  
S Siakavellas ◽  
M Lyons ◽  
I D Arnott ◽  
...  
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Biologic Therapy ◽  
Temporal Trends ◽  
Cumulative Risk ◽  
Population Based ◽  
Cumulative Probability ◽  
Cox Regression Analysis ◽  
Over Time

Abstract Background The use of biologic therapy for Crohn’s disease [CD] continues to evolve, however, the effect of this on the requirement for surgery remains unclear. We assessed changes in biologic prescription and surgery over time in a population-based cohort. Methods We performed a retrospective cohort study of all 1753 patients diagnosed with CD in Lothian, Scotland, between January 1, 2000 and December 31, 2017, reviewing the electronic health record of each patient to identify all CD-related surgery and biologic prescription. Cumulative probability and hazard ratios for surgery and biologic prescription from diagnosis were calculated and compared using the log-rank test and Cox regression analysis stratified by year of diagnosis into cohorts. Results The 5-year cumulative risk of surgery was 20.4% in cohort 1 [2000–2004],18.3% in cohort 2 [2005–2008], 14.7% in cohort 3 [2009–2013], and 13.0% in cohort 4 [2014–2017] p &lt;0.001. The 5-year cumulative risk of biologic prescription was 5.7% in cohort 1, 12.2% in cohort 2, 22.0% in cohort 3, and 44.9% in cohort 4 p &lt;0.001. Conclusions The increased and earlier use of biologic therapy in CD patients corresponded with a decreasing requirement for surgery over time within our cohort. This could mean that adopting a top-down or accelerated step-up treatment strategy may be effective at reducing the requirement for surgery in newly diagnosed CD.

scholarly journals Trends in chlamydia and gonorrhoea testing and positivity in Western Australian Aboriginal and non-Aboriginal women 2001–2013: a population-based cohort study

Sexual Health ◽  
2017 ◽  
Vol 14 (6) ◽  
pp. 574 ◽  
Author(s):  
Joanne Reekie ◽  
Basil Donovan ◽  
Rebecca Guy ◽  
Jane S. Hocking ◽  
John M. Kaldor ◽  
...  
Keyword(s):  
Age Groups ◽  
Population Based ◽  
Reproductive Age ◽  
Nucleic Acid Amplification ◽  
Effective Prevention ◽  
Aboriginal Women ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence ◽  
Over Time

Background: This study aimed to examine trends in chlamydia and gonorrhoea testing and positivity in Aboriginal and non-Aboriginal women of reproductive age. Methods: A cohort of 318002 women, born between 1974 and 1995, residing in Western Australia (WA) was determined from birth registrations and the 2014 electoral roll. This cohort was then probabilistically linked to all records of chlamydia and gonorrhoea nucleic acid amplification tests conducted by two large WA pathology laboratories between 1 January 2001 and 31 December 2013. Trends in chlamydia and gonorrhoea testing and positivity were investigated over time and stratified by Aboriginality and age group. Results: The proportion of women tested annually for chlamydia increased significantly between 2001 and 2013 from 24.5% to 36.6% in Aboriginal and 4.0% to 8.5% in non-Aboriginal women (both P-values <0.001). Concurrent testing was high (>80%) and so patterns of gonorrhoea testing were similar. Chlamydia and gonorrhoea positivity were substantially higher in Aboriginal compared with non-Aboriginal women; age-, region- and year-adjusted incidence rate ratios were 1.52 (95% confidence interval (CI) 1.50–1.69, P < 0.001) and 11.80 (95% CI 10.77–12.91, P < 0.001) respectively. Chlamydia positivity increased significantly in non-Aboriginal women aged 15–19 peaking in 2011 at 13.3% (95% CI 12.5–14.2%); trends were less consistent among 15–19-year-old Aboriginal women but positivity also peaked in 2011 at 18.5% (95% CI 16.9–20.2%). Gonorrhoea positivity was 9.7% (95% CI 9.3–10.1%), 6.7% (95% CI 6.4–7.0%), 4.7% (4.4–5.0%), and 3.1% (2.8–3.4%) among Aboriginal women aged respectively 15–19, 20–24, 25–29 and ≥30 years, compared with <1% in all age groups in non-Aboriginal women. Over time, gonorrhoea positivity declined in all age groups among Aboriginal and non-Aboriginal women. Conclusion: Between 2001 and 2013 in WA chlamydia and gonorrhoea positivity remained highest in young Aboriginal women despite chlamydia positivity increasing among young non-Aboriginal women. More effective prevention strategies, particularly for young Aboriginal women, are needed to address these disparities.

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