A laboratory network for sentinel surveillance of chlamydia: Results after 2 years of the ACCESS laboratory network (2008-2009)
All Australian diagnostic laboratories testing for chlamydia were invited to participate. Data was collected from 15 large laboratories (4 private and 11 public) representing five jurisdictions, between 2008 and 2009. Laboratories extracted demographic and chlamydia testing data from their information systems which were de-identified with a non-reversible unique code using GRHANITE® software. We describe testing rates and the proportion positive (positivity) by patient demographic characteristics.
A total of 416,996 test results were collated; 69% (288,671) were in 16-29 year olds; 210,405 (73%) were women and 78,266 (27%) men. Chlamydia positivity was higher in 16-29 year old men (11.5%, (95%CI:11.3-11.8) than women (7.6%,95%CI:7.4-7.7). Chlamydia positivity declined steadily as age increased for both women and men; positivity rates among women aged 16-19, 20-24 and 25-29 years were 11.7%, 7.9% and 4.4%, respectively, and positivity rates among men aged 16-19, 20-24 and 25-29 years were 14.4%, 12.9% and 8.8%, respectively.
The ACCESS Laboratory Network successfully implemented the first national laboratory-based sentinel surveillance system for chlamydia, representing 50-70% of total testing by integrating public and private laboratory data. The findings show more women than men are being tested, high positivity rates, and positivity declines as age increases highlighting the need for strategies to increase testing among young people, particularly men. The ACCESS Laboratory Network provides a platform for potential expansion to other sexually transmissible infections to inform and evaluate prevention initiatives.
