Contact tracing in a regional sexual health clinic : audit outcomes and implications for sexually transmissible infection control

Objective: To evaluate contact tracing outcomes in a regional sexual health clinic (SHC) and to investigate contact tracing outcome measures. Method: A retrospective audit of contact tracing activities for all 126 cases of Chlamydia trachomatis, 19 cases of Neisseria gonorrhoeae and two cases of early syphilis diagnosed during 2004 was conducted at a regional SHC in Queensland, Australia. Results: Patient referral was used for almost all contact tracing. The ratio of index cases to contacts reported by the index case as known to be treated and seen at the clinic was 1:0.71 and 1:0.26 respectively. Ratios of index cases to contacts for chlamydial infection and gonorrhoea were similar. Records identified that past partners were treated less often than current regular partners and were rarely seen at the clinic. The ratio of total index cases to total clients seen as contacts, including contacts of index cases diagnosed elsewhere, was 1:0.52. Implications: Improving information and resources for index cases should be a priority of any contact tracing program, with a focus on strategies to increase contact tracing of past partners. A method of evaluating contact tracing processes can include summary outcome data such as the ratio of total index cases to total clients seen as contacts and the proportion of contacts testing positive. Such measures may be useful in evaluating new contact tracing strategies and may also be applicable for the development of a national standard for contact tracing.