Notes
Outline
Avon Surveillance System for Sexually Transmitted Infections
Wendi Slater, SW Public Health Observatory
Nicola Low, University of Bristol
on behalf of the ASSIST Project Steering Group
"Why we need to improve..."
Why we need to improve STI surveillance
The ASSIST project
Example analysis
Chlamydia diagnosed in GUM clinics by gender: England 1996 - 2001
Gonorrhoea diagnosed in GUM clinics by gender: England 1996 - 2001
Syphilis diagnosed in GUM clinics by gender: England 1996 - 2001
STIs not equitably distributed
Teenagers and young adults
People in deprived inner cities
Particular minority ethnic groups
Men who have sex with men
National Sexual Health Strategy
Launched July 2001
Includes:
Better prevention
Developing primary care services
Targeting Chlamydia Screening
Improving Surveillance
Limitations of Current Surveillance
Mostly based GUM clinic activity
Limited information
Can’t analyse at small geographical level
Not timely
Increasing diagnosis in other settings
Proposed national data collection from GUM clinics
Person based data on attendances and diagnosis including:
Postcode Sector
Date of Birth
Gender
Sexuality
Ethnicity
Aim of ‘ASSIST’ Project
Collect person based data from all providers
Analyse infection rates and associations with age, sex, ethnicity, deprivation etc.
Compare provider activity levels
Provide timely information locally
Add value to national work
Slide 11
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ASSIST Project Collaboration
Sexual health service providers
Microbiology Laboratories
Health Protection Agency
SW Public Health Observatory
University of Bristol
Relationship between service providers and laboratories in Avon
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Confidentiality & Security Issues
STI person-identifying information particularly sensitive
Comply with national legislation & guidance
Secure transfer of data & restrict access
Remove person identifying information at earliest opportunity
Approval & backing
SW Multi-centre Research Ethics Committee (MREC)
Local clinicians & microbiologists
Caldicott Guardians
Seeking ‘Section 60’ approval
Data quality – complete & valid
Test & Diagnosis: 100%
Date of Birth: almost 100%
Name/Soundex code: almost 100%
Postcodes: 75%
Ethnicity 75% (GUM)
Validation exercise within GUM clinics
Summary of Cross-boundary Flow: % GUM clinic attendances by PCT of residence
Milne Centre Diagnosed Gonorrhoea Year 2000 by Ethnic Group
Milne Centre Gonorrhoea rates per 100K population by Ethnic Group
Chlamydia Tests at PHLS Bristol Year 2001 by provider
Positive Chlamydia test results at PHLS Bristol Year 2001 by provider
Total GP Practice Chlamydia Testing by Age Group
Recent trends in 5 GP Practices who undertake the most Chlamydia testing
Conclusion
Existing surveillance system poor
Proposed national enhanced collection from GUM clinics – only part of the picture
ASSIST project feasible
Can add value to national work
Could extend to other areas in the UK
For further information:
Wendi Slater
South West Public Health Observatory
Tel.