Reinhold Muller

James Cook University, Townsville, Queensland, Australia

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Publications (76)141.25 Total impact

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    ABSTRACT: http://www.ics.org/Abstracts/Publish/241/000426.pdf
    No preview · Conference Paper · Oct 2015
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    ABSTRACT: Objective: Although soil-transmitted helminths (STH) are endemic in Solomon Islands, there are few recent reports on their prevalence. This study aimed to determine the prevalence of STH in residents of remote communities in Solomon Islands. Methods: A cross-sectional convenience-sampled survey of residents of four adjacent villages in Malaita, Solomon Islands was performed in Atoifi and Na’au in April 2011 and in Abitona and Sifilo in April 2012. All residents older than one year were invited to participate, which involved providing a single sample of faeces examined using a modified Kato-Katz technique and completing a questionnaire that asked demographic and STH-related behaviour questions. Results: The overall participation rate was 52.8%, with 402 participants comprising 49.8% males. Hookworm was the predominant STH with only a single case of trichuriasis found in Atoifi. The total prevalence of hookworm was 22.6% (95% confidence interval: 18.6–27.1); the prevalence of hookworm in Abitona, Na’au and Sifilo was 20.0%, 29.9% and 27.4%, respectively, whereas in Atoifi it was 2.3% (P < 0.001). Intensity was low in all villages. Although health behaviours differed significantly between Atoifi and the other three villages, the type of toilet used was the only significant association with hookworm. Discussion: Residents of Atoifi have a relative freedom from STH compared to the other three villages. Rather than a region-wide morbidity control approach, a “one village at a time” approach aiming to eliminate STH and dealing with each village as a separate autonomous unit empowered to manage its own challenges may be a preferred option.
    Full-text · Article · Jul 2015
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    ABSTRACT: To examine the correlation between HIV prevalence and male circumcision and other foreskin cutting practices across the four regions of Papua New Guinea (PNG). An ecological substudy using unique data from an interdisciplinary research programme to evaluate the acceptability, sociocultural context and public health impact of male circumcision for HIV prevention in PNG. Published data describing (a) self-reported circumcision status by region from the 'Acceptability and Feasibility of Male Circumcision for HIV prevention in PNG' study and (b) HIV prevalence by region from PNG National Department of Health were used to correlate male circumcision and other foreskin cutting practices and HIV prevalence. Maps were constructed to visually represent variations across the four regions of PNG. Regions of PNG with the highest HIV prevalence had the lowest prevalence of male circumcision and other forms of foreskin cutting and vice versa. Male circumcision and dorsal longitudinal cuts were strongly associated with HIV prevalence and able to explain 99% of the observed geographical variability in HIV prevalence in PNG (p<0.01). The regional prevalence of HIV infection in PNG appears to be closely correlated with the regional distribution of male circumcision and dorsal longitudinal foreskin cuts. Further research is warranted to investigate causality of this correlation as well as the potential of dorsal longitudinal cuts to confer protection against HIV acquisition in heterosexual men. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    Full-text · Article · Jun 2015 · Sexually transmitted infections
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    ABSTRACT: to evaluate objective and subjective outcomes of MiniArc and Monarc midurethral sling (MUS) in women with stress incontinence at 12 months STUDY DESIGN: 225 women were randomized to receive MiniArc or Monarc. Women with intrinsic sphincter deficiency, previous MUS or untreated detrusor overactivity were excluded. Objective cure was defined as negative cough stress test (CST) with a comfortably full bladder. Subjective cure was defined as no report of leakage with coughing or exercise on questionnaire. Validated questionnaires, together with urodynamic and clinical cough stress test were used to evaluate objective and subjective outcomes following surgery. Participants and clinicians were not masked to treatment allocation. Outcomes were compared with exact binomial tests (e.g. Fischer's Exact test for dichotomous data) for categorical data and Student t tests or exact versions of Wilcoxon tests for numerical data as appropriate. There was no statistically significant difference in the subjective (92.2% vs 94.2%, p=0.78; difference 2.0%, 95%CI[-2.7%, +6.7%]) or objective (94.4% vs 96.7%, p=0.50; difference 2.3%, 95%CI[-1.5%, +6.1%]) cure rates between MiniArc and Monarc at 12m respectively, with a significant improvement in overactive bladder outcomes and incontinence impact from baseline in both arms. MiniArc outcomes are not inferior to Monarc MUS outcomes at 12 months follow up in women without intrinsic sphincter deficiency. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Jan 2015 · American Journal of Obstetrics and Gynecology
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    Rick Speare · Benjamin Speare · Reinhold Muller · Phil Bishop
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    ABSTRACT: Because anesthesia of amphibian larvae is currently problematic, the aim of this study was to test if a fish anesthetic containing approximately 500 g/L isoeugenol (Aqui-S) could anesthetize tadpoles. Three concentrations of Aqui-S were tested (of commercial solution 10, 20, and 50 microl/L) with 10 tadpoles of the southern brown tree frog (Litoria ewingii) per concentration. Tadpoles were anesthetized for 15 min in water at 18-20 degrees C. Anesthetic criteria included four time points and two heart rates: time to loss of response to stimulation, loss of righting reflex, and return of spontaneous movement and of righting reflex after removal from Aqui-S, and heart rate after induction and after 15 min of anesthesia. No tadpole showed signs of irritation or excitement, no tadpole died, and all returned to normal behavior. The times for induction of anesthesia (time to loss of righting reflex) decreased significantly (P < 0.001) with increasing concentration: means of 27.5, 16.8, and 5.7 min for 10, 20, and 50 microl/L, respectively. Heart rate after 15 min of anesthesia was significantly lower (P = 0.006) for concentrations of 20 and 50 microl/L compared to 10 microl/L. At the lowest concentration (10 microl/L), anesthesia was light. Recovery times were significantly delayed (P < 0.001) for 50 microl/L, approximately double those for the lower concentrations. Spontaneous movements began at 56.9, 51.4, and 119 min for 10, 20, and 50 microl/L Aqui-S, respectively. Although Aqui-S did anesthetize tadpoles at all three concentrations, with 20 microl/L being the most suitable, additional longer-term toxicity testing is required prior to its adoption as an anesthetic agent for this species. Anesthesia, isoeugenol, Litoria ewingii, southern brown tree frog, tadpoles.
    Full-text · Article · Sep 2014 · Journal of Zoo and Wildlife Medicine
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    ABSTRACT: In 2002/03 the Queensland Government responded to high rates of alcohol-related harm in discrete Indigenous communities by implementing alcohol management plans (AMPs), designed to include supply and harm reduction and treatment measures. Tighter alcohol supply and carriage restrictions followed in 2008 following indications of reductions in violence and injury indicators. Despite the plans being in place for over a decade, no comprehensive independent review has assessed to what level the designed aims were achieved and what effect the plans have had on Indigenous community residents and service providers. This study will describe the long-term impacts on important health, economic and social outcomes of Queensland's AMPs. The project has two main studies, 1) outcome evaluation using de-identified epidemiological data on injury, violence and other health and social indicators for across Queensland, including de-identified databases compiled from relevant routinely-available administrative data sets, and 2) a process evaluation to map the nature, timing and content of intervention components targeting alcohol. Process evaluation will also be used to assess the fidelity with which the designed intervention components have been implemented, their uptake and community responses to them and their perceived impacts on alcohol supply and consumption, injury, violence and community health. Interviews and focus groups with Indigenous residents and service providers will be used. The study will be conducted in all 24 of Queensland's Indigenous communities affected by alcohol management plans. This evaluation will report on the impacts of the original aims for AMPs, what impact they have had on Indigenous residents and service providers. A central outcome will be the establishment of relevant databases describing the parameters of the changes seen. This will permit comprehensive and rigorous surveillance systems to be put in place and provided to communities empowering them with the best credible evidence to judge future policy and program requirements for themselves. The project will inform impending alcohol policy and program adjustments in Queensland other Australian jurisdictions.The project has been approved by the James Cook University Human Research Ethics Committee (approval number H4967 & H5241).
    Full-text · Article · Jan 2014 · BMC Public Health
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    ABSTRACT: To evaluate the clinical performance of two chlamydia point-of-care (POC) tests compared with a gold standard nucleic acid amplification testing (NAAT). Tests evaluated were the Chlamydia Rapid Test (CRT), Diagnostics for the Real World and the ACON Chlamydia Rapid Test Device, ACON Laboratories (ACON). Overall 226 men and 225 women in Port Vila, Vanuatu, participated in this prospective study in 2010. NAAT and POC testing was performed on samples of male urine and female vaginal swabs for 156 men and 223 women (CRT), and 133 men and 75 women (ACON). The sensitivity and specificity of the CRT in men were 41.4% (95% CI 23.5% to 61.1%) and 89.0% (95% CI 82.2% to 93.8%), respectively, and in women 74.2% (95% CI 61.5% to 84.5%) and 95.7% (95% CI 91.3% to 98.2%), respectively; for ACON, they were 43.8% (95% CI 19.8% to 70.1%) and 98.3% (95% CI 93.9% to 99.8%) in men, and in women 66.7% (95% CI 22.3% to 95.7%) and 91.3% (95% CI 82.0% to 96.7%), respectively. Both tests were (absolutely) insensitive at organism loads less than 1000 (log=3) per mL or per swab; the CRT sensitivity was significantly lower at loads less than, compared with those greater than, 100 000 (log=5) per mL or per swab. The performance of both CRT and ACON is well below the levels stated by the manufacturers. The evaluated tests are unlikely to be helpful in clinical settings due to the high proportion of false-negatives that will go untreated and false-positives that will result in overtreatment and potential adverse social consequences.
    Full-text · Article · Dec 2013 · Sexually transmitted infections
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    D V Canyon · R Muller
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    ABSTRACT: Insecticide applications are not particularly effective on Aedes aegypti mosquitoes which has been attributed to their 'closet' behaviour, or ability to rest in places that remain unexposed to insecticides. Some researchers have suggested that insecticides repel mosquitoes, which would result in less exposure and increased dispersal. If repellence due to insecticides is a fact, acquiring a vector-borne disease, such as dengue, could legitimately be attributed to local vector control efforts and this would lead to restitution claims. This study thus investigated the effect of insecticide presence on mosquito behaviour indirectly via oviposition and directly via olfactory response. In all experiments, oviposition in each insecticide compared to its water and ethanol controls was not significantly different. This indicates that Ae. aegypti mosquitoes are not affected by insecticide presence and that increased dispersal is unlikely to be caused by vector control spraying.
    Full-text · Article · Dec 2013 · Tropical biomedicine
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    ABSTRACT: When a parasite finds a new wildlife host, impacts can be significant. In the late 1980s populations of Spectacled Flying-foxes (SFF) (Pteropus conspicillatus), a species confined, in Australia, to north Queensland became infected by paralysis tick (Ixodes holocyclus), resulting in mortality. This Pteropus-tick relationship was new to Australia. Curiously, the relationship was confined to several camps on the Atherton Tableland, north Queensland. It was hypothesised that an introduced plant, wild tobacco (Solanum mauritianum), had facilitated this new host-tick interaction. This study quantifies the impact of tick paralysis on SFF and investigates the relationship with climate. Retrospective analysis was carried out on records from the Tolga Bat Hospital for 1998-2010. Juvenile mortality rates were correlated to climate data using vector auto-regression. Mortality rates due to tick paralysis ranged between 11.6 per 10,000 bats in 2003 and 102.5 in 2009; more female than male adult bats were affected. Juvenile mortality rates were negatively correlated with the total rainfall in January to March and July to September of the same year while a positive correlation of these quarterly total rainfalls existed with the total population. All tick affected camps of SFF were located in the 80% core range of S. mauritianum. This initial analysis justifies further exploration of how an exotic plant might alter the relationship between a formerly ground-dwelling parasite and an arboreal host.
    Full-text · Article · Sep 2013 · PLoS ONE
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    ABSTRACT: Male circumcision (MC) reduces HIV acquisition and is a key public health intervention in settings with high HIV prevalence, heterosexual transmission and low MC rates. In Papua New Guinea (PNG), where HIV prevalence is 0.8%, there is no medical MC program for HIV prevention. There is however many different foreskin cutting practices across the country's 800 language groups. The major form exposes the glans but does not remove the foreskin. This study aimed to describe and quantify foreskin cutting styles, practices and beliefs. It also aimed to assess the acceptability of MC for HIV prevention in PNG. Cross-sectional multicentre study, at two university campuses (Madang Province and National Capital District) and at two 'rural development' sites (mining site Enga Province; palm-oil plantation in Oro Province). Structured questionnaires were completed by participants originating from all regions of PNG who were resident at each site for study or work. Questionnaires were completed by 861 men and 519 women. Of men, 47% reported a longitudinal foreskin cut (cut through the dorsal surface to expose the glans but foreskin not removed); 43% reported no foreskin cut; and 10% a circumferential foreskin cut (complete removal). Frequency and type of cut varied significantly by region of origin (p < .001). Most men (72-82%) were cut between the ages of 10 -- 20 years. Longitudinal cuts were most often done in a village by a friend, with circumferential cuts most often done in a clinic by a health professional. Most uncut men (71%) and longitudinal cut men (84%) stated they would remove their foreskin if it reduced the risk of HIV infection. More than 95% of uncut men and 97% of longitudinal cut men would prefer the procedure in a clinic or hospital. Most men (90%) and women (74%) stated they would remove the foreskin of their son if it reduced the risk of HIV infection. Although 57% of men reported some form of foreskin cut only 10% reported the complete removal of the foreskin, the procedure on which international HIV prevention strategies are based. The acceptability of MC (complete foreskin removal) is high among men (for themselves and their sons) and women (for their sons). Potential MC services need to be responsive to the diversity of beliefs and practices and consider health system constraints. A concerted research effort to investigate the potential protective effects of longitudinal cuts for HIV acquisition is essential given the scale of longitudinal cuts in PNG.
    Full-text · Article · Sep 2013 · BMC Public Health
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    Sam Young · Jeff Warner · Rick Speare · Lee Berger · Lee F Skerratt · Reinhold Muller

    Full-text · Dataset · Jun 2013
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    D V Canyon · R Muller · L K Hii J
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    ABSTRACT: Weather variations have clear associations with the epidemiology of dengue fever and populations of Aedes aegypti mosquitoes. Data on humidity associations, however, lags with respect to its effect on host-biting, nectar-seeking and survival. This experimental study on Ae. aegypti, sourced from the arid tropics, investigated the effect of low and high relative humidity and diet in relation to host-biting, temporal variations in feeding frequency, and mosquito mortality. In each environmental setting, 10 replicates, containing one male and five female mosquitoes, were challenged with different nutritional sources every six hours over 12 days. Results showed that host-biting did not diminish in low humidity and was six times higher than expected. Sucrose feeding was observed to significantly moderate host-biting and water alone was inadequate for survival. The high host-biting rates help to explain the intensity of dengue epidemics, while the ability of the mosquito to disregard adverse humidity-related conditions helps to explain how dengue epidemics in arid tropical regions can be just as devastating as those in the wet tropics.
    Full-text · Article · Mar 2013 · Tropical biomedicine
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    Sam Young · Jeff Warner · Rick Speare · Lee Berger · Lee F Skerratt · Reinhold Muller
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    ABSTRACT: Few hematologic and biochemical reference intervals for wild amphibians have been established. Reference values would aid in early detection of emerging infectious diseases, which are a significant problem for amphibian conservation efforts. We aimed to establish reference intervals for a wide range of hematologic and plasma biochemistry variables for 2 species of Australian tree frogs, describe morphologic features of leukocytes, and analyze the effects of season, year, and parasite status on blood values. Blood specimens were collected from reference populations of wild adult Australian tree frogs, Litoria caerulea and L infrafrenata, for analysis of hematologic (manual) variables, plasma biochemical (automated) analytes, and plasma and serum proteins using automated methods, refractometry, and electrophoresis. Inter- and intraspecies differences were found in L caerulea (n = 80) and L infrafrenata (n = 66) frogs for hematologic and biochemical variables. Intraspecies differences were largely associated with seasonal variations. In the dry season, both species had higher WBC counts, with higher lymphocyte counts in L caerulea and higher neutrophil counts in L infrafrenata, and uric acid concentrations. In the wet season, both species had higher glucose and potassium concentrations, L caerulea frogs had higher neutrophil counts, and L infrafrenata frogs had higher total protein, phosphorus, and sodium concentrations, AST activity, PCV, hemoglobin concentration, and RBC, thrombocyte, and basophil counts. Hemogregarines were identified in 19% of blood samples from L infrafrenata frogs; multiple hematologic and biochemical variables were altered in infected frogs. Wide interspecies and seasonal variations highlight the need to establish species- and season-specific reference intervals for amphibians. Hematologic and plasma biochemical reference values should be useful in assessing the health status and in detecting emerging diseases in wild amphibians.
    Full-text · Article · Dec 2012 · Veterinary Clinical Pathology
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    ABSTRACT: Background: Chlamydia trachomatis (chlamydia) is the most commonly notified sexually transmissible bacterial infection in Australia, where distance to health services can be a barrier. This study investigated the acceptability of a self-collection kit for chlamydia testing (sent by mail) and assessed the risk profiles of participants with respect to locality. Methods: In total, 2587 self-collection kits were distributed opportunistically or sent directly to participants upon request, as was a self-administered questionnaire. Results: The return rate was 13.2% (n=341) for samples and questionnaires. The return rate did not differ with location (P=0.522) but with mode of distribution (opportunistic: 9.7%; by request: 27.4%; P<0.001). Although 37% of participants had previously been tested for chlamydia, 77.5% said that they would not have sought testing otherwise. The median age of participants was 22.6 years, 33.8% were male and 9.1% were of Aboriginal descent. Overall, 9.0% (95% confidence interval (CI)=6.1-12.5) of participants were chlamydia-positive. Prevalence of chlamydia and Aboriginal participation increased with remoteness (P<0.001), and self-reported condom use was significantly reduced for remote and very remote locations (P=0.008). Within remote and very remote locations, 30.8% (95% CI=9.1-61.4) of Aboriginal participants and 38.9% of non-Indigenous participants were chlamydia-positive (P=0.718; 95% CI=17.3-64.3). Discussion: Testing for chlamydia using a mailed self-collection kit opened access to a predominantly test-naïve population. The proposed model was able to reach remote populations. Actively requested kits were more likely to be returned.
    Full-text · Article · Nov 2012 · Sexual Health
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    ABSTRACT: To assess a mailed self-collection kit for chlamydia testing as an intervention to increase post-treatment retesting rates. This prospective intervention study took place at a sexual health clinic in Townsville, North Queensland (Australia) between 2006 and 2008. The intervention consisted of offering to mail a self-collection kit for retesting 3 months after treatment. The achieved retesting rates were compared to those from the previous year and to concurrent controls who did not participate in the intervention. Both control groups received standard advice on retesting. Of the 46 participants in the intervention group, 34.8% returned the sample for retesting 3 to 4 months after initial treatment, in comparison to 6.8% of the historic control groups (n=206) and 1.4% of the concurrent control group (n=142) (P<0.001, respectively). Retesting rates for Chlamydia trachomatis were substantially and significantly improved using the mailed self-collection kit evidencing that the kit could deliver a much needed intervention to improve notoriously low retesting rates.
    Full-text · Article · Jun 2011 · Sexual Health
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    ABSTRACT: To document rates of serious injuries in relation to government alcohol restrictions in remote Australian Indigenous communities. An ecological study using Royal Flying Doctor Service injury retrieval data, before and after changes in legal access to alcohol in four remote Australian Indigenous communities, Queensland, 1 January 1996-31 July 2010. Changes in rates of aeromedical retrievals for serious injury, and proportion of retrievals for serious injury, before and after alcohol restrictions. After alcohol restrictions were introduced in 2002-2003, retrieval rates for serious injury dropped initially, and then increased in the 2 years before further restrictions in 2008 (average increase, 2.34 per 1000 per year). This trend reversed in the 2 years after the 2008 restrictions (average decrease, 7.97 per 1000 per year). There was a statistically significant decreasing time trend in serious-injury retrieval rates in each of the four communities for the period 2 years before the 2002-2003 restrictions, 2 years before the 2008 restrictions, and the final 2 years of observations (2009-2010) (P < 0.001 for all four communities combined). Overall, serious-injury retrieval rates dropped from 30 per 1000 in 2008 to 14 per 1000 in 2010, and the proportions of serious-injury retrievals decreased significantly for all four communities. The absolute and the proportional rates of serious-injury retrievals fell significantly as government restrictions on legal access to alcohol increased; they are now at their lowest recorded level in 15 years.
    No preview · Article · May 2011 · The Medical journal of Australia
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    Full-text · Article · Jan 2011 · Sexual Health
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    Yik N Lim · Peter Dwyer · Reinhold Muller · Anna Rosamilia · Joseph Lee · Kobi Stav
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    ABSTRACT: There is currently no data on the safety and efficacy of the Advantage sling despite its widespread use. We compared the efficiency and safety outcome data of 556 tension-free vaginal tape (TVT) and 108 Advantage slings after assessing for potential confounding factors. The two groups proved comparable. Bladder injury rates were 4.6% for the Advantage group and 2.9% for the TVT group (p = 0.36). Subjective stress incontinence cure were 83.3% and 85.3%, respectively (p = 0.66). Incidences of de novo urgency, urge incontinence, and voiding difficulties were 22.2% vs 14.7% (p = 0.06), 9.3% vs 7.4% (p = 0.55), and 11.1% vs 6.7% (p = 0.11), respectively. No major differences between the two slings were observed apart from a non-significant trend towards more de novo urgency and voiding difficulty symptoms with the Advantage group. It may be possible that due to its different biomechanical properties, the Advantage slings should be left looser.
    Full-text · Article · May 2010 · International Urogynecology Journal
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    ABSTRACT: To develop, implement and evaluate the processes of a novel approach to chlamydia testing that is accessible, confidential, free of charge, easy to use, and allows for self-collection of specimens, their transportation by regular mail and the central management of results. A 'self-collection kit' was developed including all items and instructions necessary to obtain a sample. A network of distribution sites at locations frequented by the target population has been established. The 'kits' can be requested via an advertised website and by phone. Specimens are returned via reply paid mail. A centralised system for the management of results and follow up has been established. Test results are conveyed by the participant's method of choice. Treatment is organised via a network of health care providers. Of the first 100 returned kits 99% were safely packed and 86% were sent back with a completely filled out pathology request form. Ninety-two participants provided contact details; 70.7% indicated mobile phone or SMS as the preferred methods to receive results. Seven positive cases were identified and treatment was confirmed for all within 6 days. These findings provide evidence that the presented approach to chlamydia testing is easy to implement, achieves excellent follow-up and treatment rates, and therefore opens important new channels to otherwise difficult to access high-risk populations, such as young people and geographically and socially isolated populations.
    Full-text · Article · Jul 2009 · Sexual Health
  • Monika Buhrer-Skinner · Reinhold Muller · Arun Menon · Rose Gordon
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    ABSTRACT: A prospective study was undertaken to develop an evidence-based outreach chlamydia screening program and to assess the viability and efficiency of this complementary approach to chlamydia testing within the routine operations of a primary healthcare service. A primary healthcare service based in Townsville, Queensland, Australia, identified high-prevalence groups for chlamydia in the community. Subsequently, a series of outreach clinics were established and conducted between August 2004 and November 2005 at a defence force unit, a university, high school leavers' festivities, a high school catering for Indigenous students, youth service programs, and backpacker accommodations. All target groups were easily accessible and yielded high participation. Chlamydia prevalence ranged between 5 and 15% for five of the six groups; high school leavers had no chlamydia. All participants were notified of their results and all positive cases were treated (median treatment interval 7 days). Five of the six assessed groups were identified as viable for screening and form the basis for the ongoing outreach chlamydia screening program. The present study developed an evidence-based outreach chlamydia screening program and demonstrated its viability as a complementary approach to chlamydia testing within the routine operations of the primary healthcare service, i.e. without the need for additional funding. It contributes to the evidence base necessary for a viable and efficient chlamydia management program. Although the presented particulars may not be directly transferable to other communities or health systems, the general two-step approach of identifying local high-risk populations and then collaborating with community groups to access these populations is.
    No preview · Article · Apr 2009 · Sexual Health

Publication Stats

2k Citations
141.25 Total Impact Points

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Institutions

  • 1998-2015
    • James Cook University
      • • Anton Breinl Centre for Public Health & Tropical Medicine
      • • Discipline of Medicine
      • • School of Public Health, Tropical Medicine and Rehabilitation Sciences
      Townsville, Queensland, Australia
  • 2014
    • Clonal Solutions Australia Pty Ltd
      Mareeba, Queensland, Australia