An outbreak-driven emergency department screening program for syphilis in North Queensland’s Aboriginal and Torres Strait Islander population
Moncrieff, Leah, Lawton, Luke, Hall, Leanne, Edmondson, Katie, Menon, Arun, and Heal, Clare (2025) An outbreak-driven emergency department screening program for syphilis in North Queensland’s Aboriginal and Torres Strait Islander population. Sexual Health, 22 (5). SH25055.
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Abstract
Background: There is an ongoing syphilis outbreak in regional and rural areas of Australia, with Aboriginal and Torres Strait Islander peoples disproportionately represented in notification data. Innovative screening approaches are needed in healthcare settings frequented by at-risk communities. The emergency department (ED) was hypothesised to be an ideal location for screening Aboriginal and Torres Strait Islander peoples, who traditionally underutilise healthcare services. Methods: A quality improvement initiative introduced an opt-out syphilis screening program at the Townsville University Hospital ED. For Aboriginal and Torres Strait Islander clients aged 15–40 years, syphilis screening was automatically added to blood tests collected as part of routine care. A retrospective audit of the program assessed screening rates, diagnosis, linkage to treatment and contact tracing outcomes. Results: The program added 5471 tests for 3942 individuals within the target age range. Twenty-seven Aboriginal and Torres Strait Islander peoples were diagnosed with syphilis infections requiring treatment, indicating a 0.68% prevalence. The odds of untreated syphilis were significantly higher in the oldest age group (aged 36–40 years) compared with the youngest age group (aged 15–20 years; OR 3.88, 95% CI 1.05–14.40, P = 0.04). All diagnoses of late latent or syphilis of unknown duration (n = 5) were made in the oldest age group. One pregnant woman was diagnosed with early syphilis. All infections, except one, were successfully treated by sexual health services. Conclusion: The ED screening program effectively identified undetected syphilis cases in the Aboriginal and Torres Strait Islander population. This audit informed future adaptations to the program, including expanding the target age range and increasing the screening interval between tests. Similar ED syphilis screening protocols could be adopted by other hospitals in syphilis outbreak areas.
| Item ID: | 89979 |
|---|---|
| Item Type: | Article (Research - C1) |
| ISSN: | 1449-8987 |
| Keywords: | Australian Aboriginal and Torres Strait Islander peoples, clinical audit, emergency service, mass screening, quality improvement, sexual health, sexually transmitted infections, syphilis |
| Copyright Information: | © 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY-NC-ND) |
| Date Deposited: | 04 Aug 2026 04:32 |
| FoR Codes: | 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450417 Aboriginal and Torres Strait Islander public health and wellbeing @ 50% 42 HEALTH SCIENCES > 4202 Epidemiology > 420202 Disease surveillance @ 50% |
| SEO Codes: | 20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 50% 21 INDIGENOUS > 2103 Aboriginal and Torres Strait Islander health > 210303 Aboriginal and Torres Strait Islander health system performance @ 50% |
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