Screening tests for gonorrhoea should first do no harm

Bell et al, MJA 202(6), 6 April 2015, cite our 2012 article “Evaluating the chlamydia and gonorrhoea screening program in the Humanitarian Entrant Health Service, Western Australia as evidence for clinicians misinterpreting clinical guidelines”.1 We understand this to mean that gonorrhoea is inappropriately included in routine STI screening when only chlamydia screening is indicated. We have reviewed our references and do not believe there was any misinterpretation of the clinical guidelines available at the time of writing. This article was submitted in 2011 and the reference used was the 2008 National management guidelines for sexually transmitted infections.2 On page 6 the guidelines begin with who should have an asymptomatic sexual health screen and this was published in the article. Page 9 lists the testing required which unequivocally states testing for both chlamydia and gonorrhoea should be performed. Therefore we request that this reference be removed as evidence of “clinicians misinterpreting guidelines”. The 2008 guideline stated that testing for gonorrhoea is performed as part of an asymptomatic sexual health screen. It could be that increased gonorrhoea testing is partly accounted for by the fact that previous clinical guidelines recommended it.