Abstract
BackgroundNational notification data for sexually transmitted infections (STIs) and blood borne viruses (BBVs) continue to have a high proportion of missing data on Indigenous status, potentially biasing estimates of notification rates by Aboriginality. We evaluated the use of data linkage to improve the accuracy of estimated notification rates for STIs and BBVs in Aboriginal and non-Aboriginal groups in Western Australia.MethodsSTI and BBV case notifications in Western Australia received in 2010 were linked with administrative health data collections in Western Australia to obtain additional data on Indigenous status. STI and BBV notification rates based on the pre- and post-linkage data among Aboriginal and non-Aboriginal groups were compared.ResultsData linkage decreased the proportion of notifications with unknown Indigenous status by 74% from 10.2% to 2.7%. There was no significant difference in disease-specific age-adjusted notification rate ratio estimates based on pre-linkage data and post-linkage data for Aboriginal people compared with non-Aboriginal people.ConclusionOur findings suggest that reported STI and BBV disease-specific age-adjusted notification rates for 2010 in Western Australia are unlikely to be significantly biased by excluding notifications with unknown Indigenous status. This finding is likely to be dependent on recent improvements in the reporting of Indigenous status in notification data in Western Australia. Cost-effective and systematic solutions, including the better use of existing data linkage resources, are required to facilitate continued improvement in the completeness of reporting and accuracy of estimates for notifiable STIs and BBVs in Australia by Aboriginality.
Highlights
National notification data for sexually transmitted infections (STIs) and blood borne viruses (BBVs) continue to have a high proportion of missing data on Indigenous status, potentially biasing estimates of notification rates by Aboriginality
For each individual who was notified with a STI or BBV in 2010, data on Aboriginality were obtained from five administrative health data collections via the Western Australian Data Linkage System (WADLS)
Compared with pre-linkage notification rate ratios, we found no significant difference in age-adjusted STI and BBV notification rate ratios by Aboriginality in Western
Summary
National notification data for sexually transmitted infections (STIs) and blood borne viruses (BBVs) continue to have a high proportion of missing data on Indigenous status, potentially biasing estimates of notification rates by Aboriginality. We evaluated the use of data linkage to improve the accuracy of estimated notification rates for STIs and BBVs in Aboriginal and non-Aboriginal groups in Western Australia. Substantial deficits persist in the reporting of Indigenous status for notifications of sexually transmitted infections (STIs) and blood borne viruses (BBVs) in Australia, with approximately half of nationally notified chlamydia and hepatitis C cases, and over one third of gonorrhoea cases missing data on Aboriginality in 2010 [1]. Notifiable disease surveillance systems provide timely information for disease control policy and practice, and accurate estimation of disease notification rates by Aboriginality is critical to enable the effective evaluation of interventions to improve disease detection, treatment and prevention. Estimates based on incomplete data are influenced by the amount of incomplete data, the factors that influence incompleteness, and the degree of similarity between complete cases and incomplete cases [8]
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