The Kimberley is an endemic region, therefore the threshold for suspecting an STI should be very low. Chlamydia and gonorrhoea are often asymptomatic and can result in long term complications like pelvic inflammatory disease and infertility. STIs are easy to test for and treat to prevent these complications. In Australia Aboriginal and Torres Strait Islanders experience a disproportionate rate of Blood Borne Viruses, it is important to remember to test for these viruses.
Essential STI/BBV tests in the Kimberley include the following infections:
Chlamydia, Gonorrhoea, Trichomonasis, HIV and Syphilis. Depending on the individual’s risk determined by a clinical and sexual history testing for Hepatitis B and C should also be considered.
Kimberley is an endemic region for many STIs and there is a current Syphilis outbreak
Opportunistic screening recommendations in asymptomatic clients
- 15- 30 year olds should be tested 6 monthly & 31-40 annually for STIs.
– Co-infection is common; Where there is one, look for others – blood tests and further follow up if STI chlamydia or gonorrhoea found, best practice is to take bloods at initial visit with consent
- Antenatal screening – 3 STI tests , including blood tests. First visit, 28 weeks and 36 weeks, and re-testing if client has a new/change of partner.
- Symptomatic patients – test and treat on initial visit.
– In symptomatic females also consider empirical treatment for trichomoniasis as rates of this infection are high in remote Australia.
– 3 month follow up and re-screen is also recommended to test for re-infection.
Link to Silverbook for further information: http://ww2.health.wa.gov.au/Silver-book
SYPHILIS
The current Syphilis outbreak was declared in the Kimberley region in June 2014 with ongoing cases notified from across the region and throughout Northern Australia. The Kimberly Population Health Unit (ph: 9194 1630) maintains a Syphilis database and should be contacted for previous history before proceeding with treatment.
To control the outbreak the following key performance indicators published in the National Syphilis Guidelines are measured in the Kimberley:
- 80% of cases are investigated and treated with 2/52 of diagnosis
- 80% symptomatic cases are examined, tested and treated on first presentation
- 80% of cases of infectious syphilis have repeat syphilis serology at 3-6/12 post-treatment
- 80% of infectious syphilis cases have at least one named contact examined, tested and treated within two weeks of case treatment
- 80% named contact are examined tested and treated for syphilis with one month of being named
- 100% those dx with another STI (Chlamydia, Gonorrhoea) have a syphilis test within 1 month of diagnosis