Healthcare-seeking behaviour of people with sexually transmitted infection symptoms attending a Sexual Health Clinic in New Zealand
Untreated sexually transmitted infections (STIs) can lead to serious health complications and may be transmitted to uninfected individuals. Prior to this study, time to presentation for STI symptoms and risk of transmission in this period had not been assessed in New Zealand. This research surveyed people attending a sexual health clinic (SHC) in Wellington, New Zealand. In total, 243 people took part. The most common reason for seeking healthcare was experiencing symptoms. 41.7% of people with symptoms waited more than seven days to seek healthcare. Almost a third of people with symptoms had sex after they first thought they may need to seek healthcare. This work suggests more could be done to help people attend healthcare quicker when they experience symptoms suggestive of an STI. Some possible options could be a public health campaign explaining why taking swift action is important, or providing support and guidance to help people navigate the healthcare system.
Antimicrobial stewardship practice in New Zealand’s rural hospitals
Antimicrobial stewardship (AMS; the judicious and guided use of antibiotics) is an important concept in modern healthcare but is under-explored in rural hospital medicine. Access to AMS education and support is inconsistent in rural hospitals. While AMS is perceived to be relevant in rural hospitals, the problems it aims to prevent, including antimicrobial resistance and antimicrobial overuse are more likely to be considered as urban or overseas issues. The development of AMS strategies for rural hospitals will require special consideration of the specific environment of rural hospitals, including resourcing constraints.
Reduction in surgical site infections in the Southern Cross Hospitals network, 2004–2015: successful outcome of a long-term surveillance and quality improvement project
Although surgical wound infections are uncommon when they occur, they have a significant impact on patients. Southern Cross Hospitals has reported a 59% decrease in surgical wound infection over 12 years. A surgical wound monitoring programme, in place since 2004, attributes this outcome to quality improvement initiatives. The programme confirmed the effectiveness of two key practices: the use of alcohol-based skin preparation and enhanced timing of antibiotics given to patients. Across the period, the wound infection rate dropped from 3.5% to 1.2%, a decrease of approximately 5% a year. The most frequent cause of wound infection was from Staphylococcus aureus, commonly referred to as ‘staph’, an organism often found up the nose and from there transferred to a person’s skin or wound. Southern Cross Hospitals continues to promote practices to reduce wound infections even further.
Pro-equity climate change and environmental sustainability action by district health boards in Aotearoa/New Zealand
As outlined in the 2018 ‘Letter of Expectations’ from the Minister of Health, climate change action is now expected of DHBs. We argue that this - and all other - DHB action must be pro-equity to achieve fair health outcomes for Māori and Pacific populations. Three scenarios are proposed in the areas of DHB energy use, transport and purchasing where climate pollution could be reduced, and health determinants and outcomes for Māori and Pacific peoples improved. The scenarios show that by taking a sustainability and equity perspective, it is possible for DHBs to move beyond disease treatment to create health and equity solutions.
Implementing HIV pre-exposure prophylaxis (PrEP): let’s not get caught with our pants down
PrEP is a hugely promising new tool in the HIV prevention toolkit but it won’t stop transmission if it’s sitting on the shelf. Our concern is that people most at risk of HIV don’t know about PrEP; sexual health clinics are struggling from underfunding; GPs aren’t offering PrEP to their eligible patients; and we aren’t monitoring PrEP roll-out well enough. HIV diagnoses have been rising in NZ so getting PrEP implementation right is critical. Our grave concerns about slow PrEP implementation are reflected in two recent news stories: the congenital syphilis scandal; and poor coverage of sexuality in medical school curricula.
100 years since the 1918 influenza pandemic—progress made, yet questions remain. A synopsis of the 4th New Zealand Influenza Symposium, February 2018
Influenza pandemics cause devastating social and economic destruction worldwide, while seasonal (annual) outbreaks of influenza cause substantial illness and death that burdens healthcare services every year. The Immunisation Advisory Centre (IMAC) hosted the 4th New Zealand Influenza Symposium (NZiS) in February 2018 in Wellington. The event attracted international and national experts to discuss current influenza-related policy, immunisation practice and research. Key topics discussed were how to better prepare for the next influenza pandemic and strategies to improve policy and vaccine delivery mechanisms to better protect people, particularly vulnerable groups, against influenza.