Diagnosis of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium: an observational study of testing patterns, prevalence and co-infection rates in northern New Zealand
Arlo Upton A D , Liselle Bissessor A , Peter Lowe B , Xiaoying Wang C and Gary McAuliffe AA Microbiology Department, Labtests, 31 – 41 Carbine road, Auckland 2022, New Zealand.
B Hologic (Australia) Pty Ltd, Suite 402, Level 4, 2 Lyon Park Road, Macquarie Park NSW 2113, Australia.
C Hologic, Clinical Affair Department, Grifols Diagnostic Solutions Inc., 10210 Genetic Center Drive, San Diego, CA 92121, USA.
D Corresponding author. Email: arlo.upton@labtests.co.nz
Sexual Health 15(3) 232-237 https://doi.org/10.1071/SH17110
Submitted: 21 June 2017 Accepted: 3 October 2017 Published: 21 December 2017
Abstract
Background: This study sought to determine community prevalence, epidemiology and testing patterns for sexually transmissible infections (STI) in northern New Zealand. Methods: A total of 2643 samples submitted for STI testing between 26 November 2015 and 7 December 2015 underwent analysis by Aptima Combo 2 (Hologic, San Diego, CA, USA), Trichomonas vaginalis (TV), and Mycoplasma genitalium (MG) assays. Results were analysed by patient demographics. Results: Four hundred and eleven pathogens were detected from 359 patients, with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), TV, and MG detected in 178 (6.7%), 19 (0.7%), 80 (3%) and 134 (5.1%) samples respectively. With the exception of TV, STI prevalence was highest in people <25 years of age. Infection was more common in men for NG (odds ratio (OR) 5.05, P < 0.001) and CT (OR 2.72, P < 0.001). Māori and Pacific ethnicity were associated with increased risk of MG (OR 1.82, P = 0.006,) TV (OR 6.1, P < 0.001) and CT (OR 3.31, P < 0.001) infection, and TV and NG infections were more prevalent as social deprivation increased. A mismatch between testing rates and prevalence of infection was seen, with fewer tests performed for males (OR 0.2, P < 0.001) than females and no difference in testing of Māori and Pacific men (3064/100 000) compared with men of European background (3181/100 000, OR 0.96, P = 0.76), despite an increased risk of disease. Conclusions: There are disparately low testing rates for STIs in certain high-risk groups in northern New Zealand.
References
[1] Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N, Stevens G, Gottlieb S, Kiarie J, Temmerman M. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PLoS ONE 2015; 10 e0143304| Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting.Crossref | GoogleScholarGoogle Scholar |
[2] Lis R, Rowhani-Rahbar A, Manhart LE. Mycoplasma genitalium infection and female reproductive tract disease: a meta-analysis. Clin Infect Dis. 2015; 61 418–26.
| Mycoplasma genitalium infection and female reproductive tract disease: a meta-analysis.Crossref | GoogleScholarGoogle Scholar |
[3] de Jong AS, Rahamat-Langendoen JC, van Alphen P, Hilt N, van Herk C, Pont S, Melchers W, van de Bovenkamp J. Large two-centre study into the prevalence of Mycoplasma genitalium and Trichomonas vaginalis in the Netherlands. Int J STD AIDS 2016; 27 856–60.
| Large two-centre study into the prevalence of Mycoplasma genitalium and Trichomonas vaginalis in the Netherlands.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2sXhsVSksr%2FL&md5=e14450cfafef00fbff9ff87b151ce771CAS |
[4] Hilton J, Azariah S, Reid M. A case-control study of men with non-gonococcal urethritis at Auckland Sexual Health Service: rates of detection of Mycoplasma genitalium. Sex Health 2010; 7 77–81.
| A case-control study of men with non-gonococcal urethritis at Auckland Sexual Health Service: rates of detection of Mycoplasma genitalium.Crossref | GoogleScholarGoogle Scholar |
[5] Lawton BA, Rose SB, Bromhead C, Gaitanos LA, MacDonald EJ, Lund KA. High prevalence of Mycoplasma genitalium in women presenting for termination of pregnancy. Contraception 2008; 77 294–8.
| High prevalence of Mycoplasma genitalium in women presenting for termination of pregnancy.Crossref | GoogleScholarGoogle Scholar |
[6] Oliphant J, Azariah S. Cervicitis: limited clinical utility for the detection of Mycoplasma genitalium in a cross-sectional study of women attending a New Zealand sexual health clinic. Sex Health 2013; 10 263–7.
[7] Jensen JS, Cusini M, Gomberg M, Moi H. 2016 European guideline on Mycoplasma genitalium infections. J Eur Acad Dermatol Venereol. 2016; 30 1650–6.
| 2016 European guideline on Mycoplasma genitalium infections.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC28Xhs1yqsrvL&md5=74ea02302bb60834a3727407542149aaCAS |
[8] Getman D, Jiang A, O’Donnell M, Cohen S. Mycoplasma genitalium prevalence, coinfection, and macrolide antibiotic resistance frequency in a multicenter clinical study cohort in the United States. J Clin Microbiol 2016; 54 2278–83.
| Mycoplasma genitalium prevalence, coinfection, and macrolide antibiotic resistance frequency in a multicenter clinical study cohort in the United States.Crossref | GoogleScholarGoogle Scholar |
[9] Yew HS, Anderson T, Coughlan E, Werno A. Induced macrolide resistance in Mycoplasma genitalium isolates from patients with recurrent nongonococcal urethritis. J Clin Microbiol 2016; 49 1695–1696.
| Induced macrolide resistance in Mycoplasma genitalium isolates from patients with recurrent nongonococcal urethritis.Crossref | GoogleScholarGoogle Scholar |
[10] Lo M, Reid M, Brokenshire M. Epidemiological features of women with trichomoniasis in Auckland sexual health clinics: 1998–99. N Z Med J 2002; 115 U119
[11] Platts WM. Venereal disease in New Zealand. Br J Vener Dis 1969; 45 61–6.
| 1:STN:280:DyaF1M7ltFWktA%3D%3D&md5=9951b51cce1da842e8a2e25d534a5ceaCAS |
[12] Southwick M, Kenealy T, Ryan D. Primary care for pacific people: a pacific and health systems approach. Ministry of Health NZ. 2013 Available online at: http://www.health.govt.nz/publication/primary-care-pacific-people-pacific-and-health-systems-approach [verified 11 January 2017]
[13] Clark TC, Lucassen MF, Fleming T, Peiris-John R, Ikihele A, Teevale T, Robinson E, Crengle S. Changes in the sexual health behaviours of New Zealand secondary school students, 2001–2012: findings from a national survey series. Aust N Z J Public Health 2016; 40 329–36.
| Changes in the sexual health behaviours of New Zealand secondary school students, 2001–2012: findings from a national survey series.Crossref | GoogleScholarGoogle Scholar |
[14] Cliffe SJ, Tabrizi S, Sullivan EA, Pacific Islands Second Generation HIV Surveillance Group Chlamydia in the Pacific region, the silent epidemic. Sex Transm Dis 2008; 35 801–6.
| Chlamydia in the Pacific region, the silent epidemic.Crossref | GoogleScholarGoogle Scholar |
[15] Poole DN, McClelland RS. Global epidemiology of Trichomonas vaginalis. Sex Transm Infect 2013; 89 418–22.
| Global epidemiology of Trichomonas vaginalis.Crossref | GoogleScholarGoogle Scholar |
[16] Van Der Pol B. Clinical and laboratory testing for Trichomonas vaginalis infection. J Clin Microbiol 2016; 54 7–12.
| Clinical and laboratory testing for Trichomonas vaginalis infection.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC28Xht1SqtbrN&md5=8a011bdd078f3af20b4c5dd675cfa15dCAS |
[17] Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA. Gender differences in the utilization of health care services. J Fam Pract 2000; 49 147–52.
| 1:STN:280:DC%2BD3c7otFKhsg%3D%3D&md5=0a1adb3e0bd93534bc33f945bfa2e4ffCAS |
[18] Ellison-Loschmann L, Pearce N. Improving access to health care among New Zealand’s Māori population. Am J Public Health 2006; 96 612–7.
| Improving access to health care among New Zealand’s Māori population.Crossref | GoogleScholarGoogle Scholar |
