title: Impact of improved diagnosis and treatment on prevalence of gonorrhoea and chlamydial infection in remote aboriginal communities on Anangu Pitjantjatjara Lands.
abstract: OBJECTIVE
  To evaluate the impact of a program to improve access to, and delivery of, diagnosis and treatment on prevalence of gonorrhoea and chlamydial infection in remote Aboriginal communities.
  
  
  METHODS
  Analysis of cross-sectional data from annual age-based screening.
  
  
  METHODS
  Six remote Aboriginal communities and three homelands on the Anangu Pitjantjatjara Lands in the far north-west of South Australia, 1996-1998.
  
  
  METHODS
  All Aboriginal people aged 12-40 years listed on the Nganampa Health Council population register as resident on the Anangu Pitjantjatjara Lands.
  
  
  METHODS
  Prevalence of gonorrhoea and chlamydial infection, determined by urine polymerase chain reaction tests.
  
  
  RESULTS
  The prevalence of gonorrhoea in people aged 12-40 years almost halved, from 14.3% in 1996 to 7.7% in 1998 (test for trend: P < 0.001). The fall in prevalence of gonorrhoea was comparable and statistically significant in both men and women. Prevalence of chlamydial infection also fell, from 8.8% in men and 9.1% in women in 1996 to 7.2% in both men and women in 1998, but this decline was not statistically significant (test for trend: P = 0.174).
  
  
  CONCLUSIONS
  This study documents a rapid reduction in prevalence of gonorrhoea, probably reflecting reduced duration of infectiousness due to advances in diagnosis, increased testing activity and reduced interval to treatment rather than behaviour change. These results demonstrate that, in remote communities, even with a highly mobile population, it is possible to implement effective control activities for sexually transmitted diseases.
authors.affiliation: Nganampa Health Council, Alice Springs, NT. pjmnhc@ozemail.com.au
authors.forename: P J
authors.initials: PJ
authors.lastname: Miller
authors.forename: P J
authors.initials: PJ
authors.lastname: Torzillo
authors.forename: W
authors.initials: W
authors.lastname: Hateley
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008403:Mass Screening; D008507:Medically Underserved Area; D016133:Polymerase Chain Reaction; D015995:Prevalence; D015397:Program Evaluation; D012008:Recurrence; D013021:South Australia / Q000453:epidemiology; D000095283:Australian Aboriginal and Torres Strait Islander Peoples