Impact of improved laboratory compliance on notification of genital Chlamydia trachomatis infection in Victoria.

Background And Objectives: Although regulations in Victoria require notification of chlamydia infection by both clinician and laboratory, review found many reports that were notified only by one source (i.e., were unmatched).

Goals: To identify problems with the notification system and to improve the quality of surveillance for this disease.

Study Design: All notified cases of chlamydia diagnosed in January or February 1995 were followed up by contacting diagnosing doctors. Identified noncompliant laboratories were asked to provide a list of all diagnoses for the period and institute ongoing reporting. Notification data were reviewed for timeliness and completeness.

Results: Clinicians never notified without laboratory confirmation. Soliciting laboratory reports increased total notifications by 30%, and there was a highly significant improvement in reporting by both clinicians and laboratories. Reasons for failure to notify by clinicians included an assumption by some clinicians that laboratories would notify and ignorance that notification was required.

Conclusions: Notified cases generally are now accompanied by a laboratory report, and although nonnotification by clinicians continues, notification has improved. Further improvements in clinician notification may depend on doctors knowing that public health action results from reporting. An alternative to requiring doctors' time to be spent in duplicate notification would be to strengthen laboratory reporting and then check that adequate treatment and partner notification has occurred through contact with the diagnosing doctor.