National Healthcare Agreement: P02-Incidence of sexually transmitted infections and blood-borne viruses, 2010 QS
Identifying and definitional attributes
|Metadata item type:||Quality Statement|
|Indicators linked to this Quality statement:|
|Quality statement summary:|
Cases are reported to state governments from clinicians and laboratories under relevant public health legislation. The Department of Health and Ageing receives data for all noted diseases except for HIV on to the National Notifiable Diseases Surveillance System (NNDSS) and acts as the custodian of that data. The National Centre in HIV Epidemiology and Clinical Research, a research institute based at the University of NSW, are responsible for maintaining national HIV data reported by the jurisdictions.
The tables for this indicator were prepared by the Department of Health and Ageing and quality-assessed by the Australian Institute of Health and Welfare (AIHW). The Department of Health and Ageing drafted the initial data quality statement (including providing input about the methodology used to extract the data and any data anomalies) and then further comments were added by the AIHW, in consultation with the Department. The AIHW did not have the relevant datasets required to independently verify the data tables for this indicator. For further information see the AIHW website.
|Timeliness:||Data relates to the most recent complete year being 2008.|
The NNDSS website enables the public to access the following levels of data:
This is provided in both case count and rates outputs. See:
|Interpretability:||The current NNDSS case definitions, including any historical edits, can be found at www.health.gov.au/casedefinitions.|
All cases reported in the 0-4 years age group were notified as being congenitally acquired cases. Congenital syphilis is transmitted transplacentally from an infected pregnant woman to her foetus, and is not considered to be sexually transmitted.
Sexually Transmitted Infections (STI) are not necessarily sexually acquired
Not all notifications of chlamydial infection, gonococcal infection, and syphilis are sexually acquired. The national case definitions for these infections do not specifically distinguish between sites of infection or modes of transmission. It is known that in children under 4 years of age an STI, even of the genital area, may have been acquired from the mother at the time of delivery or via inadvertent nonsexual spread. For example, rectal and genital infection with Chlamydia trachomatis in young children may be due to persistent perinatally acquired infections, which may persist for up to three years; and gonococcal conjunctivitis can be acquired at the time of delivery or transmitted from child to child. Also, congenital syphilis is transmitted transplacentally from an infected pregnant woman to her foetus, and is not sexually transmitted.
Information about Indigenous status is only presented for jurisdictions with response rates of 50% or more to the Indigenous status data item.
Remoteness and socioeconomic status
The analyses by state/territory, remoteness and socioeconomic status are based on postcode of residence of the client as recorded in the NNDSS. Where a postcode was not available for a client, they were not included in the remoteness and SEIFA disaggregations. These postcodes consisted of post office box numbers, special NNDSS postcode formats which indicate the state of residence but not the specific postcode location, fictitious postcodes, missing postcodes and new postcodes that have not yet been assigned a category by the ABS. Over 95% of records had a postcode assigned that was able to be included in disaggregations by remoteness and socioeconomic status.
Where a postcode was allocated to more than one SEIFA or Remoteness categories, cases were allocated based on the proportion of the population allocated to the respective SEIFA or Remoteness category within a postcode.
Postcode information usually reflects the residential location of a case, however in some jurisdictions it may be based on the postcode at the time of testing.
All jurisdictions, except for the ACT, have cleared the provided data. Please note that the data supplied for the NT is preliminary and there may be revisions in the future.
A major limitation of the notification data is that, for most diseases, they represent only a proportion of the total cases occurring in the community, i.e. only those cases for which health care was sought and a diagnosis made, followed by a notification to health authorities. This proportion may vary between diseases and over time, with infections diagnosed by a laboratory test more likely to be notified. States and territories may have varying reporting requirements by medical practitioners, laboratories and hospitals, and differing levels of case follow-up.
Notifications were extracted using 'diagnosis date' for 2008. Please note the date of diagnosis is the onset date or where the date of onset was not supplied, the earliest of the specimen collection date, the notification date, or the notification receive date. As considerable time may have elapsed between the onset and diagnosis dates for hepatitis B and C unspecified cases, the earliest of specimen date, health professional notification date or public health unit notification receive date was used for these conditions.
The Department of Health and Ageing used tables and concordance files to construct population estimates. These tables and concordance files were provided by the AIHW, based on ABS statistical products.
The level of completeness of the Indigenous status data item is highly variable by disease and jurisdiction.
For National Healthcare Agreement (NHA) table 2.3, incomplete notifications where Indigenous status was ‘not stated’ or blank or unknown were counted as 'not Indigenous' and included as ‘Other Australians’. In each jurisdiction where more than 50% of notifications had a ‘not stated’, blank or ‘unknown’ response to Indigenous status data item, the disaggregation between Indigenous and Other Australians has not been provided as the data are not considered of sufficient quality to report this disaggregation.
These data need to be interpreted cautiously as STI screening occurs disproportionately among Indigenous populations and high rates in Indigenous populations may be attributed to poorer access to primary health care services and not necessarily associated with increased levels of sexual activity among Indigenous persons.
Hepatitis B and C
All notifications of hepatitis B and C have been included regardless of whether they were notified as "newly acquired" or as "greater than 2 years or unspecified period of infection". The two categories have been combined to represent all new diagnoses of hepatitis B and C within 2008 and not just newly acquired infections. This is due to inconsistent follow-up of cases between jurisdictions (required to determine the true date of acquisition).
Sex of cases
Where the sex of the case was either unknown or not reported, these cases were included in the 'total' data for each state and Australia.
Cells have been suppressed to protect confidentiality (where the presentation could identify a person or a single service provider), where rates are highly volatile (for example, the denominator is very small), or data quality is known to be of insufficient quality (for example, where Indigenous identification rates are low).
Changes in surveillance and testing practices over time and by jurisdiction may make comparisons both over time and across jurisdictions difficult.
Changes in the national case definitions for the requirements of what constitutes a case will also affect the coherence of the data over time. The current NNDSS case definitions, including any historical edits, can be found at www.health.gov.au/casedefinitions.
|Related metadata references:|
Has been superseded by National Healthcare Agreement: PI 02-Incidence of sexually transmitted infections and blood-borne viruses, 2011 QS
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