Publications by authors named "L M Causer"

Introduction: Decentralized molecular testing for infectious disease diagnosis at the point-of-care (POC) is critical to address inequities in access to timely, informed health care. The COVID-19 pandemic accelerated the demand, development and adoption of POC tests for infectious diseases globally. This has provided opportunities to maximize the individual benefits and public health impact of POC testing, particularly in remote and resource-limited primary care settings.

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Objectives: To estimate notification rates for infectious syphilis in women of reproductive age and congenital syphilis in Australia.

Study Design: Retrospective cohort study; analysis of national infectious syphilis and enhanced congenital syphilis surveillance data.

Setting, Participants: Women aged 15-44 years diagnosed with infectious syphilis, and babies with congenital syphilis, Australia, 2011-2021.

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Article Synopsis
  • A national program integrated molecular point-of-care (POC) testing for chlamydia, gonorrhoea, and trichomonas in 49 primary care clinics in Australia to improve diagnostic access and treatment speed for First Nations peoples.
  • Between 2016 and 2022, the program showed a significant increase in monthly testing, and treated a higher percentage of patients within two to seven days compared to previous practices, resulting in thousands of infectious days averted.
  • The evaluation revealed high test concordance rates and low failure rates, indicating that the POC testing was effective and of high quality, contributing to both individual health benefits and potentially reducing disease transmission in First Nations communities.
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In April 2020, the Aboriginal and Torres Strait Islander COVID-19 Point-of-Care (POC) Testing Program was initiated to improve access to rapid molecular-based SARS-CoV-2 detection in First Nations communities. At capacity, the program reached 105 health services across Australia. An external review estimated the program contributed to averting between 23,000 and 122,000 COVID-19 infections within 40 days of the first infection in a remote community, equating to cost savings of between AU$337 million and AU$1.

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The WHO's Asia-Pacific framework for triple elimination recommends that countries evaluate their programs for the elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B (EMTCT), including identifying gaps to improve program planning and the implementation of elimination strategies in antenatal care (ANC) services. In 2022, the Indonesian Ministry of Health reported that only 39% of pregnant women were tested for HIV, 14% for syphilis, and 28% for hepatitis B, respectively. We conducted a qualitative study involving a focus group discussion (FGD) and in-depth interviews with 25 key stakeholders in Bali and West Nusa Tenggara Provinces to identify specific challenges to testing for HIV, syphilis, and hepatitis B in ANC settings.

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