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Quality of Sexually Transmitted Infection Clinical Management and Contact Tracing Outcomes in a Remote Area of High Sexually Transmitted Infection Endemicity

Mak, Donna B. MBBS, MPH*†‡; Plant, Aileen J. MBBS, MPH, PhD; Bulsara, Max K. BSc, MSc

Sexually Transmitted Diseases: August 2004 - Volume 31 - Issue 8 - p 449-454
doi: 10.1097/01.olq.0000135983.89474.91

Objectives: The objectives of this study were to assess health professionals’ adherence to Western Australian sexually transmitted infection (STI) management guidelines and to document the outcomes of contact tracing in a remote Indigenous setting.

Methods: This article comprises 2 parts: a retrospective clinical audit of quality of clinical STI management and outcomes of contact tracing and an analysis of completeness of relevant laboratory investigations.

Results: Documented clinical STI management of index cases varied from 94% receiving treatment in accordance with the Guidelines, whereas only 48% underwent a clinical examination. Sexual contacts who underwent STI consultation had concordant (30%) and discordant (17%) STI(s). The proportion of patients with STI(s) in whom all appropriate laboratory investigations had been requested increased from 25% in 1998 to 9% to 49% in 2001–2002.

Conclusions: This study demonstrates that quality of clinical STI management comparable to that observed overseas is possible despite the challenges of healthcare delivery in a remote setting.

In an area of high STI endemicity in remote Australia, indicators of the quality of STI clinical management (with the exceptions of contact tracing timeless and completeness improved significantly between 1998 and 2001–2002.

From the *Kimberley Public Health Unit (formerly), the †School of Population Health, The University of Western Australia, and the ‡Division of Health Sciences, Curtin University of Technology, Western Australia

The authors thank Graeme Johnson and Rebecca Quake (resident medical officers) who were involved in collection and preliminary analysis of the data. Special thanks to the Kimberley Public Health Unit’s Disease Control team (1997–2002) for their unwavering commitment to STI control.

The views expressed are those of the authors and may not reflect the views of the institutions which they were employed by, or affiliated with, during the writing of this paper.

Correspondence: Donna B. Mak, MPH, 29 Cooper St., Nedlands, WA 6009, Australia. E-mail:

Received for publication October 23, 2003, and accepted March 22, 2004.

© Copyright 2004 American Sexually Transmitted Diseases Association