Graham Simon, Guy Rebecca J, Ward James S, Kaldor John, Donovan Basil, Knox Janet, McCowen Debbie, Bullen Patricia, Booker Julie, O'Brien Chris, Garrett Kristine, Wand Handan C
Kirby Institute, UNSW Australia, Sydney, NSW, 2052, Australia.
Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3052, Australia.
BMC Health Serv Res. 2015 Sep 30;15:437. doi: 10.1186/s12913-015-1116-5.
For the past two decades, chlamydia has been the most commonly notified infectious disease among young people (15-29 year olds) in Australia, the United States of America and the United Kingdom and rates have increased annually in these three countries. In Australia, rates of chlamydia are three times higher in Aboriginal compared with non-Aboriginal people. Australian sexually transmissible infection guidelines recommend annual chlamydia testing for 15-29 year old females and males. This analysis will examine the incidence and predictors of annual chlamydia testing in 15-29 year olds attending four Aboriginal Community Controlled Health Services (ACCHS) in Australia.
From 2009-2011, attendance and chlamydia testing data were extracted from the patient system to calculate the number and proportion of 15-29 year olds that were tested for chlamydia and that tested positive for chlamydia by gender (male, female), age-group (15-19, 20-24, 25-29 years), Aboriginal status (Aboriginal, non-Aboriginal people) and by the four ACCHSs sites (1, 2, 3 and 4). A cohort was created to calculate the incidence rate per 100 person-years (PY) and predictors of an annual chlamydia test (a test within 12-months of a previous test/visit) by the above factors using Cox regression. Unadjusted and adjusted hazard ratios (AHR) and their 95 % confidence intervals (CIs) and p-values were calculated with significance at p < 0.05.
From 2009-2011, there were 2896 individuals who attended the four ACCHSs. Overall , 17 % (22 % of females and 10 % of males) were tested for chlamydia and 9 % tested positive (8 % of females and 14 % of males). The median time to an annual chlamydia test was 10.7 months. The cohort included 2318 individuals. Overall the incidence rate of an annual chlamydia test was 9.1 per 100 PY (11.6 in females and 5.8 in males). Predictors of an annual chlamydia test were being female (AHR: 1.7, 95 % CI: 1.2-2.2, p < 0.01), being 15-19 years old (AHR: 1.6, 95 % CI: 1.1-2.3, p < 0.01) and attending ACCHS site 2 (AHR: 3.8, 95 % CI: 1.8-8.0, p < 0.01).
This analysis highlights that opportunistic STI testing strategies are needed to increase annual chlamydia testing in young people; especially males.
在过去二十年中，衣原体感染一直是澳大利亚、美国和英国15至29岁年轻人中报告最多的传染病，且这三个国家的感染率逐年上升。在澳大利亚，原住民衣原体感染率是非原住民的三倍。澳大利亚性传播感染指南建议对15至29岁的男性和女性进行年度衣原体检测。本分析将研究澳大利亚四家原住民社区控制卫生服务机构（ACCHS）中15至29岁人群年度衣原体检测的发生率及预测因素。
2009年至2011年期间，从患者系统中提取就诊和衣原体检测数据，按性别（男、女）、年龄组（15至19岁、20至24岁、25至29岁）以及原住民身份（原住民、非原住民）和四个ACCHS机构地点（1、2、3和4），计算接受衣原体检测以及衣原体检测呈阳性的15至29岁人群的数量和比例。创建一个队列，使用Cox回归按上述因素计算每100人年的发病率以及年度衣原体检测（上次检测/就诊后12个月内的检测）的预测因素。计算未调整和调整后的风险比（AHR）及其95%置信区间（CI）和p值，p<0.05具有统计学意义。
2009年至2011年期间，有2896人前往四家ACCHS机构就诊。总体而言，17%（女性为22%，男性为10%）接受了衣原体检测，9%检测呈阳性（女性为8%，男性为14%）。年度衣原体检测的中位时间为10.7个月。该队列包括2318人。总体而言，年度衣原体检测的发病率为每100人年9.1例（女性为11.6例，男性为5.8例）。年度衣原体检测的预测因素为女性（AHR：1.7，95%CI：1.2 - 2.2，p<0.01）、年龄在15至19岁（AHR：1.6，95%CI：1.1 -
2.3，p<0.01）以及前往ACCHS机构2就诊（AHR：3.8，95%CI：1.8 - 8.0，p<0.0
1）。
本分析强调需要采取机会性性传播感染检测策略，以提高年轻人尤其是男性的年度衣原体检测率。
