scholarly journals Latent tuberculosis infection among contacts of patients with multidrug-resistant tuberculosis in New South Wales, Australia

2021 ◽  
pp. 00149-2021
Author(s):  
Vicky Chang ◽  
Raphael Hongxi Ling ◽  
Kavindhran Velen ◽  
Greg J. Fox
Keyword(s):  
Prophylactic Treatment ◽  
New South ◽  
New South Wales ◽  
Latent Tuberculosis ◽  
Preventive Treatment ◽  
Preventive Therapy ◽  
Screening Tests ◽  
Contact Tracing ◽  
South Wales ◽  
Mdr Tb

BackgroundContacts of an individual with active tuberculosis (TB) disease, have a higher risk of developing latent TB infection (LTBI) or active TB disease. Contact tracing is a public health measure that seeks to identify exposed contacts, screen them for co-prevalent TB, and consider prophylactic treatment to prevent progression from LTBI to active TB disease. The investigators sought to determine the prevalence of LTBI and active TB disease amongst MDR-TB contacts in New South Wales (NSW).MethodologyA retrospective cohort study was performed among the contacts of patients diagnosed with MDR-TB between 2000 and 2016, inclusive, at seven chest clinics. Medical records were used to identify eligible contacts. Outcomes of screening and prophylactic treatment regimens offered to MDR-TB contacts with LTBI were characterised. Collected data included demographic information, screening tests results, and initial management.ResultsA total of 247 MDR-TB contacts of 55 MDR-TB patients were identified. LTBI was identified in 105 (42.5%) contacts. Preventive treatment was received by 20 (32.3%) contacts with LTBI, in the form of various regimens, ranging from one to three antimicrobials, with various doses and durations. One contacts with LTBI, untreated, were noted to have progressed to active TB disease during the study period, according to clinic notes.ConclusionContacts of MDR-TB have a high prevalence of LTBI. Management of these contacts varies substantially in NSW, reflecting a lack of definitive evidence for preventive therapy. Further research is required to determine the optimal management of this population.

scholarly journals Robust test and trace strategies can prevent COVID-19 resurgences: a case study from New South Wales, Australia

2020 ◽  
Author(s):  
RM Stuart ◽  
Romesh G. Abeysuriya ◽  
Cliff C. Kerr ◽  
Dina Mistry ◽  
Daniel J. Klein ◽  
...  
Keyword(s):  
New South ◽  
Effective Means ◽  
New South Wales ◽  
High Mobility ◽  
Contact Tracing ◽  
Testing Rate ◽  
South Wales ◽  
Australian State ◽  
History Of ◽  
Dynamic Community

AbstractBackgroundThe early stages of the COVID-19 pandemic illustrated that SARS-CoV-2, the virus that causes the disease, has the potential to spread exponentially. Therefore, as long as a substantial proportion of the population remains susceptible to infection, the potential for new epidemic waves persists even in settings with low numbers of active COVID-19 infections, unless sufficient countermeasures are in place. In this study, we examine the Australian state of New South Wales, a setting with prolonged low transmission, high mobility, non-universal mask usage, and a well-functioning test-and-trace system. We investigate how vulnerable the state would be to resurgences in COVID-19 transmission under variations in the levels of testing, tracing, and mask usage.MethodsWe use a stochastic agent-based model, calibrated to the New South Wales epidemic and policy environment, to simulate possible epidemic outcomes over October 1 – December 31, 2020, under a range of assumptions about contact tracing efficacy, testing rates, and mask uptake.ResultsWe find that the relative impact of masks is greatest when testing and tracing rates are lower (and vice versa). With very high testing rates (90% of people with symptoms, plus 90% of people with a known history of contact with a confirmed case), we estimate that the epidemic would remain under control until at least the end of 2020, with as little as 70–110 new infections estimated over October 1 – December 31 under high mask uptake scenarios, or 340–1,400 without masks, depending on the efficacy of community contact tracing. However, across comparable levels of mask uptake and contact tracing, the number of infections over this period would be up to 6 times higher if the testing rate was 80% instead of 90%, 17 times higher if the testing rate was 65%, or more than 100 times higher with a 50% testing rate.ConclusionsOur work suggests that testing, tracing and masks can all be effective means of controlling transmission in dynamic community settings. A multifaceted strategy that combines all three, alongside continued hygiene and distancing protocols, is likely to be the most robust means of controlling community-based transmission of SARS-CoV-2.

What are Women Told about Pap Smears That Lack Endocervical Cells?

1995 ◽  
Vol 2 (2) ◽  
pp. 105-108 ◽  
Author(s):  
Margot J Schofield ◽  
Julie E Byles ◽  
Rob Sanson-Fisher
Keyword(s):  
Pap Smear ◽  
New South ◽  
New South Wales ◽  
Pap Test ◽  
Screening Tests ◽  
Pap Smears ◽  
Test Results ◽  
South Wales ◽  
Definition Of ◽  
Test Result

Background — Debate exists about the definition of what constitutes an adequate Pap smear and about the recommended rescreening interval for Pap smears lacking an endocervical component. This study aimed at determining whether women are currently informed about the endocervical status of their Pap smears and what rescreening recommendations are made to women whose smears lack endocervical cells. Method — Consecutive Pap smears lacking an endocervical component were identified from pathology records. After obtaining consent from the referring doctor, 165 women were interviewed by telephone. Results — Only 110 (67%) of 165 women received active notification of their Pap test result and only six (4%) were aware that their smear lacked endocervical cells. Thirteen (8%) had been advised to have a repeat smear within three months. Nearly half the women reported that they would like more information about their result. Conclusions — It seems that current Pap smear notification patterns for women in New South Wales could be improved. One third are not actively informed at all about their results, and few are given detailed information about their Pap test results. Methods of enhancing the level of information women are given about their medical and screening tests need to be improved.

scholarly journals Effectiveness of digital contact tracing for COVID-19 in New South Wales, Australia

2021 ◽  
Author(s):  
Florian Vogt ◽  
Bridget Haire ◽  
Linda Selvey ◽  
John Kaldor
Keyword(s):  
Public Health ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
New South ◽  
New South Wales ◽  
Contact Tracing ◽  
Health Staff ◽  
South Wales ◽  
Public Health Staff ◽  
Close Contacts

Background: Digital proximity tracing applications were rolled out early in the COVID-19 pandemic in many countries to complement conventional contact tracing. Empirical evidence about their benefits for pandemic response remains scarce. We evaluated the effectiveness and usefulness of 'COVIDSafe', Australia's national smartphone-based proximity tracing application for COVID-19. Methods: In this prospective study, conducted in New South Wales, Australia between May and November 2020, we calculated the positive predictive value and sensitivity of COVIDSafe, its additional contact yield, and the number of averted public exposure events. Semi-structured interviews with public health staff were conducted to assess the application's usefulness. Results: There were 619 confirmed COVID-19 cases and over 25,300 close contacts during the study period. COVIDSafe was used by 137 (22%) cases and detected 79 (0.3%) close contacts. It had a positive predictive value of 39% and a sensitivity of 15%, and detected 17 (0.07%) additional close contacts that were not identified by conventional contact tracing. The application generated a substantial additional workload for public health staff and was not considered useful. Conclusions: COVIDSafe was not sufficiently effective to make a meaningful contribution to the COVID-19 response in Australia's most populous state over a 6-month period. This contrasts optimistic projections from modelling studies about the added value of digitally supported contact tracing. We found no evidence that it adds value to conventional contact tracing, and recommend that their implementation should always include comprehensive effectiveness evaluations.

scholarly journals Role of masks, testing and contact tracing in preventing COVID-19 resurgences: a case study from New South Wales, Australia

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045941
Author(s):  
Robyn M Stuart ◽  
Romesh G Abeysuriya ◽  
Cliff C Kerr ◽  
Dina Mistry ◽  
Dan J Klein ◽  
...  
Keyword(s):  
New South ◽  
Effective Means ◽  
New South Wales ◽  
High Mobility ◽  
Contact Tracing ◽  
Testing Rate ◽  
South Wales ◽  
Australian State ◽  
History Of

ObjectivesThe early stages of the COVID-19 pandemic illustrated that SARS-CoV-2, the virus that causes the disease, has the potential to spread exponentially. Therefore, as long as a substantial proportion of the population remains susceptible to infection, the potential for new epidemic waves persists even in settings with low numbers of active COVID-19 infections, unless sufficient countermeasures are in place. We aim to quantify vulnerability to resurgences in COVID-19 transmission under variations in the levels of testing, tracing and mask usage.SettingThe Australian state of New South Wales (NSW), a setting with prolonged low transmission, high mobility, non-universal mask usage and a well-functioning test-and-trace system.ParticipantsNone (simulation study).ResultsWe find that the relative impact of masks is greatest when testing and tracing rates are lower and vice versa. Scenarios with very high testing rates (90% of people with symptoms, plus 90% of people with a known history of contact with a confirmed case) were estimated to lead to a robustly controlled epidemic. However, across comparable levels of mask uptake and contact tracing, the number of infections over this period was projected to be 2–3 times higher if the testing rate was 80% instead of 90%, 8–12 times higher if the testing rate was 65% or 30–50 times higher with a 50% testing rate. In reality, NSW diagnosed 254 locally acquired cases over this period, an outcome that had a moderate probability in the model (10%–18%) assuming low mask uptake (0%–25%), even in the presence of extremely high testing (90%) and near-perfect community contact tracing (75%–100%), and a considerably higher probability if testing or tracing were at lower levels.ConclusionsOur work suggests that testing, tracing and masks can all be effective means of controlling transmission. A multifaceted strategy that combines all three, alongside continued hygiene and distancing protocols, is likely to be the most robust means of controlling transmission of SARS-CoV-2.

Prevalence of Chlamydia trachomatis infection among 'high risk' young people in New South Wales

Sexual Health ◽  
2006 ◽  
Vol 3 (4) ◽  
pp. 253 ◽  
Author(s):  
Melissa Kang ◽  
Arlie Rochford ◽  
Victoria Johnston ◽  
Julie Jackson ◽  
Ellie Freedman ◽  
...  
Keyword(s):  
High Risk ◽  
Chlamydia Trachomatis ◽  
Young People ◽  
New South ◽  
New South Wales ◽  
Contact Tracing ◽  
Sexually Active ◽  
Chlamydia Trachomatis Infection ◽  
South Wales ◽  
Sexually Transmissible Infections

International research on homeless adolescents has found that incidence and prevalence of sexually transmissible infections is relatively high. This study reports on a chlamydia prevalence survey conducted among high-risk young people (14–25 years) in New South Wales. The participants were recruited from youth health centres, which target homeless and high-risk youth. Of 333 clients (42.6% male), 84.1% were sexually active and mean number of sexual partners over the preceding 3 months was 1.4. Among sexually active participants, 24.6% claimed to use condoms always and 25% never. Sixteen of 274 available urine samples tested positive for Chlamydia trachomatis infection. Further research is warranted to better define high-risk groups and clarify the nature of associations between various factors impacting on sexual health. Most importantly, research is now called for into effective strategies for engaging and attracting young people to screening, treatment and contact tracing.

scholarly journals Screening for latent tuberculosis infection by an Aboriginal Community Controlled Health Service, New South Wales, Australia, 2015

2019 ◽  
Vol 10 (4) ◽  
pp. 24-30
Author(s):  
Hannah Visser ◽  
Megan Passey ◽  
Emma Walke ◽  
Sue Devlin
Keyword(s):  
Health Service ◽  
New South ◽  
New South Wales ◽  
Age Distribution ◽  
Preventive Treatment ◽  
Indigenous Communities ◽  
Aboriginal Community ◽  
X Ray ◽  
South Wales ◽  
Chest X Ray

Objective: Ongoing transmission of tuberculosis (TB) continues in Indigenous communities in New South Wales (NSW), Australia. In a pilot project, a Public Health Unit TB team partnered with an Aboriginal Community Controlled Health Service (ACCHS) in a community with a cluster of TB to augment screening for latent TB infection (LTBI) using interferongamma release assay (IGRA). This study examined screening data and programme outcomes at 12 months post hoc to advise practice and policy formulation. Methods: We conducted a retrospective, cross-sectional analysis of demographic and clinical data of ACCHS patients, stratified by IGRA testing status. Differences in sex and age distribution between the groups and cases of a genetically and epidemiologically linked TB cluster in Aboriginal people in NSW were assessed using non-parametric tests. Results: Of 2019 Aboriginal and Torres Strait Islander people seen by general practitioners during the study period, 135 (6.7%) participated in the screening. Twenty-four (17.8%) participants were IGRA positive. One person was diagnosed with active TB. Twelve participants received a chest X-ray at the time of the positive test, and six participants had an additional chest X-ray within 12 months. None commenced preventive treatment for LTBI. Discussion: ACCHS screening for LTBI reached individuals in the age group most commonly affected by TB in these Aboriginal communities. No conclusions can be made regarding the population prevalence due to the low screening rate. Further strategies need to be developed to increase appropriate follow-up and preventive treatment.

Sign in / Sign up

Export Citation Format

Share Document