Projects

The Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS)

Background
In Australia, national surveillance for sexually transmitted infections (STIs) and blood borne viruses (BBVs) is passive, in that it is based on reports by clinicians or laboratories of newly diagnosed cases of STI and BBV infection to local state and territory departments.
Passive surveillance has demonstrated that the number of many STIs diagnoses, particularly chlamydia, has increased sharply over the past decade. The main limitation to passive surveillance is that it is dependent on the extent of testing, which may vary across population groups and over time. For STIs such as chlamydia, which is commonly asymptotic, the notification rate is an underestimate of the true prevalence as many cases go undetected. It is therefore difficult to assess time trends or geographic patterns of infection with any confidence. ACCESS is designed to fill the information gaps of passive surveillance.

Aims
The main aim of ACCESS is to establish a comprehensive surveillance system that will help to evaluate the impact of interventions designed to control a range of STIs and BBVs in Australia and will underpin Australia’s strategic response to STIs and BBVs.

Design & Method
The ACCESS project (The Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of STIs and BBVs) is a collaboration between the Burnet Institute, the Kirby Institute and NRL in partnership with numerous other stakeholders and participating sites.

ACCESS involves four separate sentinel surveillance networks that provide important and unique information on testing and positivity of a range of STIs and BBVs in a range of priority populations: young heterosexuals, men who have sex with men; Indigenous people; and sex workers. The four networks are:

  1. Sexual health clinics (SHCs);
  2. Primary Health Care Clinics (FPCs, including general practices and Family Planning Clinics);
  3. Aboriginal Community Controlled Health Services (ACCHSs); and
  4. Diagnostic Laboratories.

Routine clinical data is extracted directly from existing Patient Management Systems in the clinical networks. Laboratory data is extracted directly from Laboratory Information Systems. No additional testing is required in most networks. Data extracted is de-identified to ensure anonymity and confidentiality of individuals accessing the various clinics involved with ACCESS.

Progress/Update
Data are regularly collated from the clinical sites and laboratories and used to interpret passive surveillance trends and inform service provision planning. Numerous publications and reports have been prepared based on the ACCESS data: http://www.access-study.org/.

Timeline

Ongoing

Results

Numerous publications and reports have been prepared based on the ACCESS data: http://www.access-study.org/

Outcomes

How is the system useful for sentinel sites?

ACCESS provides site specific reports that describe how many individuals were tested, the characteristics of these individuals and the proportion who test positive. This information has enhanced the capacity of sites to observe local chlamydia trends in priority and other relevant groups and raise awareness about testing at the sites.

How is the system useful for state/territory health departments?

ACCESS contributes to national and state specific site reports by describing how many individuals were tested, the characteristics of these individuals and the proportion who test positive. This information has enhanced the jurisdictions ability to interpret passive surveillance chlamydia trends.

Collaborators

ACCESS is a collaboration between Burnet Institute, Kirby Institute and NRL in partnership with numerous other stakeholders and participating sites.

Funding

ACCESS received funding from NSW Health, the Victorian Department of Health, the Northern Territory Department of Health and ACT Health in 2013. ACCESS was funded by the Commonwealth Department of Health and Ageing between 2007-2010.

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Contact Details

For any general enquiries relating to this project, please contact:

Caroline van Gemert

Epidemiologist

Telephone

+61 3 9282 2243

Email

carolinevg@burnet.edu.au