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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 13-April-2007, Vol 120 No 1252

This Issue of the Journal
Risk factors and characteristics of patients with gonorrhoea presenting to Auckland Sexual Health Service, New Zealand
S Azariah, N Perkins
Institute for Environmental Science & Research (ESR) data demonstrate that gonorrhoea rates in the Auckland region have been steadily rising over the last 5 years. An audit of cases presenting to Auckland Sexual Heath Service over 6 months found that the most common risk factors for acquiring gonorrhoea were age under 25 and being of Maori or Pacific ethnicity. Reasons for ethnic differences in gonorrhoea rates in New Zealand are not well understood—more research is needed. Consistent condom use was found to lower the risk of acquiring gonorrhoea, so condoms should continue to be a major component of any health promotion strategy aimed at reducing incidence of sexually transmitted infections (STIs). Antibiotic resistance in gonorrhoea isolates has also been steadily increasing in Auckland, in common with other countries in the Western Pacific region—this is concerning, as alternatives to current treatments may be difficult to find.
Chlamydia screening in Wellington Family Planning Association (FPA) clinics: a demonstration project
M Sparrow, H Lewis, P Brown, C Bromhead, D Fernando, A Maitra
Chlamydia, a common STI, is recognised as a major problem in young persons in New Zealand. A relatively simple urine test is available to screen for the disease and this is fortunate because the disease can be present and cause harm without there being any symptoms, especially in women where chlamydia is a major cause of infertility. Unless they are tested, sexually active young persons may be carrying the disease and unknowingly passing it on to partners. Although staff at FPA are trained to screen for this infection, many potentially infected clients remain unscreened. In this study we wished to demonstrate that improvements could be made to screening practices that were feasible and practical for busy staff and acceptable to clients. Over 6 months (at FPA clinics in Wellington, Lower Hutt, and Porirua) we offered screening to all young persons, and carried out 2533 screening tests. We found 8% were positive for chlamydia, and infection was more likely in those with a history of partner change and in Māori and Pacific ethnic groups. Those least likely to be infected were those who always used condoms. These results largely confirm what has been found in other studies. Our main interest was in improving screening procedures and influencing staff attitudes to screening. Successful screening relied very much on the participation of trained receptionists and nurses. For all staff, time was the greatest barrier to screening. For clients, the requirement not to have passed urine within the last hour was the main reason for not screening. Clients found the procedures very acceptable.
Health outcomes for diabetes patients returning for three annual general practice checks
A Tomlin, S Dovey, M Tilyard
Diabetes patients in New Zealand may receive free annual general practice examinations for their diabetes as part of the Get Checked program. This study examined changes (between the first examination and the third examination 2 years later) in the health status of South Island patients with Type 1 or Type 2 diabetes. There were significant improvements in the control of blood pressure and cholesterol levels and in the number of patients receiving eye and foot examinations. There was, however, no overall improvement in the control of blood sugar levels. The quality of care provided to diabetes patients enrolled in this program is improving.
Treatment of anaphylaxis in adults: results of a survey of doctors at Dunedin Hospital, New Zealand
S Thain, J Rubython
This survey looked at how doctors proposed to treat a patient with a severe allergic reaction (anaphylaxis). Most doctors knew the appropriate drug to give (adrenaline), but only 20% knew how much to give and how to give it. 20% of doctors questioned proposed giving a potentially harmful dose of the drug. Given that anaphylaxis is a potentially life-threatening condition, all doctors should know how to treat it.
     
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