Hengel Belinda, Wand Handan, Ward James, Rumbold Alice, Garton Linda, Taylor-Thomson Debbie, Silver Bronwyn, McGregor Skye, Dyda Amalie, Mein Jacqueline, Knox Janet, Maher Lisa, Kaldor John, Guy Rebecca
Apunipima Cape York Health Council, Cairns, PO Box 12045, Earlville, Qld 4870, Australia.
Kirby Institute, UNSW Australia, Wallace Wurth Building, Kensington, NSW 2052, Australia.
Sex Health. 2017 Jun;14(3):274-281. doi: 10.1071/SH16123.
In high-incidence Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) settings, annual re-testing is an important public health strategy. Using baseline laboratory data (2009-10) from a cluster randomised trial in 67 remote Aboriginal communities, the extent of re-testing was determined, along with the associated patient, staffing and health centre factors.
Annual testing was defined as re-testing in 9-15 months (guideline recommendation) and a broader time period of 5-15 months following an initial negative CT/NG test. Random effects logistic regression was used to determine factors associated with re-testing.
Of 10559 individuals aged ≥16 years with an initial negative CT/NG test (median age=25 years), 20.3% had a re-test in 9-15 months (23.6% females vs 15.4% males, P<0.001) and 35.2% in 5-15 months (40.9% females vs 26.5% males, P<0.001). Factors independently associated with re-testing in 9-15 months in both males and females were: younger age (16-19, 20-24 years); and attending a centre that sees predominantly (>90%) Aboriginal people. Additional factors independently associated with re-testing for females were: being aged 25-29 years, attending a centre that used electronic medical records, and for males, attending a health centre that employed Aboriginal health workers and more male staff.
Approximately 20% of people were re-tested within 9-15 months. Re-testing was more common in younger individuals. Findings highlight the importance of recall systems, Aboriginal health workers and male staff to facilitate annual re-testing. Further initiatives may be needed to increase re-testing.
在沙眼衣原体（CT）和淋病奈瑟菌（NG）高发病率地区，年度重新检测是一项重要的公共卫生策略。利用来自67个偏远原住民社区的整群随机试验的基线实验室数据（2009 - 2010年），确定了重新检测的程度以及相关的患者、人员配备和健康中心因素。
年度检测定义为在初次CT/NG检测呈阴性后的9 - 15个月（指南推荐）以及更宽泛的5 - 15个月时间段内进行重新检测。采用随机效应逻辑回归来确定与重新检测相关的因素。
在10559名年龄≥16岁且初次CT/NG检测呈阴性的个体（中位年龄 = 25岁）中，20.3%在9 - 15个月内进行了重新检测（女性为23.6%，男性为15.4%，P<0.001），35.2%在5 - 15个月内进行了重新检测（女性为40.9%，男性为26.5%，P<0.001）。在9 - 15个月内与男性和女性重新检测独立相关的因素为：年龄较小（16 - 19岁、20 - 24岁）；以及就诊于主要接待（>90%）原住民的中心。与女性重新检测独立相关的其他因素为：年龄在25 - 29岁、就诊于使用电子病历的中心，对于男性而言，就诊于雇佣了原住民健康工作者和更多男性工作人员的健康中心。
约20%的人在9 - 15个月内进行了重新检测。重新检测在较年轻个体中更为常见。研究结果凸显了召回系统、原住民健康工作者和男性工作人员对于促进年度重新检测的重要性。可能需要进一步采取举措来增加重新检测。
