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Chlamydia retesting and retest positivity rates: results from a state-wide laboratory data linkage study in Tasmania,
Nicola Stephens1, David Coleman2, Kelly Shaw3
1Communicable Disease Epidemiology and Surveillance, Health Protection Branch, Victorian Department of Health and Human Services, Melbourne, Vic. 3000, Australia.
Abstract:
Background Chlamydia re-infection increases the likelihood of adverse long-term sequelae. Clinical guidelines recommend retesting at 3-12 months for individuals with positive results, to detect re-infections. Retesting and test positivity levels were measured in young people who previously tested positive for chlamydia infection.
Methods:
All chlamydia tests conducted during 2012-13 in Tasmanian residents aged 15-29 years were linked. Retesting and retest positivity rates were calculated by sex, age, socioeconomic indicators and test timeframe.
Results:
Retesting rates were higher in females than males at 3 months (14.5%, n=242/1673 vs 10%, n=71/721) (P<0.01) and 12 months (27%, 265/968 vs 24%, 98/410) (P=0.24). The retesting rate was higher in females living in areas of most disadvantage (35.5%, 154/434) compared with areas of middle and least disadvantage (26% 139/534) (P<0.01). Males were more likely than females to retest positive at 3 months (35%, 25/71 vs 23%, 55/242) (P<0.01); retest positivity at 12 months was 32% in both sexes (males 98/140; females 265/968). Retest positivity was higher in males living in areas of least disadvantage (43%, 3/7) compared with middle (24%, 16/67) (P=0.27) and most (27%, 10/37) (P=0.09); and higher in females living in areas of least disadvantage (39%, 7/18) compared with middle (24%, 29/121) (P<0.01) and most (31%, 48/154) (P=0.02).
Conclusions:
Retesting rates are low in Tasmania and retest positivity is high, reinforcing the importance of promoting safer sex practices, partner notification and treatment, and retesting.