A decision to end a periodic syphilis-screening program in the Kimberley region.

Syphilis rates in the Kimberley region of far-northern Western Australia are among the highest in the nation. In 1986, a formal program of periodic syphilis screening was established. Decreasing syphilis rates since the early 1990s prompted, in 1999, re-evaluation of the value of periodic screening. All confirmed cases of syphilis identified in the Kimberley between January 1996 and early December 1999 as a result of syphilis serology were classified by reason for the test and staged according to disease progression. During the study period, 196 cases of syphilis (117 male, 79 female) were diagnosed; 14 (7.1%) were primary, 32 (16.3%) secondary and 150 (76.5%) latent. The periodic screening program contributed only about 10 per cent of cases, whereas testing as a result of sexually transmitted disease symptoms, sexually transmitted disease contact, institutional screening and other screening contributed the remaining cases. In January 2000, the periodic syphilis-screening program was discontinued. The effect of this policy change will be closely monitored using indicators to ensure that, should the decision not to screen prove to have been misjudged, any increase in syphilis incidence is detected early and managed appropriately.