Gonorrhoea testing and positivity in non-remote Aboriginal Community Controlled Health Services
Mary Ellen Harrod A , Sophia Couzos B , James Ward C , Mark Saunders D , Basil Donovan E , Belinda Hammond F , Dea Delaney-Thiele G H , Mary Belfrage I , Sid Williams J , Lucy Watchirs Smith E and John M. Kaldor E KA NSW Users and AIDS Association, Level 5, 414 Elizabeth Street, Surry Hills, NSW 2012, Australia.
B James Cook University, 1 James Cook Drive, Townsville, Qld 4811, Australia.
C South Australian Health & Medical Research Institute, North Terrace, Adelaide, SA 5001, Australia.
D National Aboriginal Community Controlled Health Organisation, 3/221 London Circuit, Braddon, ACT 2612, Australia.
E Kirby Institute, Lv6, Wallace Wurth Building, University of New South Wales, Sydney, NSW 2052, Australia.
F Nunkuwarrin Yunti of South Australia Inc., 28 Brady Street, Elizabeth Downs, SA 5000, Australia.
G School of Public Health & Community Medicine, Samuels Avenue, University of New South Wales, Sydney, NSW 2052, Australia.
H Nepean Aboriginal Health Service Ltd, 454–456 High Street, Penrith, NSW 2751, Australia.
I Victorian Aboriginal Health Service, 186 Nicholson Street, Fitzroy, Vic. 3065, Australia.
J Goondir Health Services, 4 Jimbour Street, Dalby, Qld 4405, Australia.
K Corresponding author. Email: Jkaldor@kirby.unsw.edu.au
Sexual Health 14(4) 320-324 https://doi.org/10.1071/SH16046
Submitted: 18 March 2016 Accepted: 23 January 2017 Published: 23 June 2017
Abstract
Background: Gonorrhoea occurs at high levels in young Aboriginal and Torres Strait Islander people living in remote communities, but there are limited data on urban and regional settings. An analysis was undertaken of gonorrhoea testing and positivity at four non-remote Aboriginal Community Controlled Health Services participating in a collaborative research network. Methods: This was a retrospective analysis of clinical encounter data derived from electronic medical records at participating services. Data were extracted using the GRHANITE program for all patients aged 15–54 years from 2009 to 2013. Demographic characteristics and testing and positivity for gonorrhoea were calculated for each year. Results: A total of 2971 patients (2571 Aboriginal and/or Torres Strait Islander) were tested for gonorrhoea during the study period. Among Aboriginal and/or Torres Strait Islander patients, 40 (1.6%) tested positive. Gonorrhoea positivity was associated with clinic location (higher in the regional clinic) and having had a positive chlamydia test. By year, the proportion of patients aged 15–29 years tested for gonorrhoea increased in both men (7.4% in 2009 to 15.9% in 2013) and women (14.8% in 2009 to 25.3% in 2013). Concurrent testing for chlamydia was performed on 86.3% of testing occasions, increasing from 75% in 2009 to 92% in 2013. Factors related to concurrent testing were sex and year of test. Conclusions: The prevalence of gonorrhoea among young Aboriginal and/or Torres Strait Islander people in non-remote settings suggests that the current approach of duplex testing for chlamydia and gonorrhoea simultaneously is justified, particularly for women.
References
[1] Whiley DM, Goire N, Lahra MM, Donovan B, Limnios AE, Nissen MD, Sloots TP. The ticking time bomb: escalating antibiotic resistance in Neisseria gonorrhoeae is a public health disaster in waiting. J Antimicrob Chemother 2012; 67 2059–61.| The ticking time bomb: escalating antibiotic resistance in Neisseria gonorrhoeae is a public health disaster in waiting.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38Xht1egt73L&md5=95e4af8a41accf1a60868ac8e3855eb1CAS |
[2] Silver BJ, Guy RJ, Wand H, Ward J, Rumbold AR, Fairley CK, Donovan B, Maher L, Dyda A, Garton L, Hengel B, Knox J, McGregor S, Taylor-Thomson D, Kaldor JM, on behalf of the STRIVE investigators. Incidence of curable sexually transmissible infections among adolescents and young adults in remote Australian Aboriginal communities: analysis of longitudinal clinical service data. Sex Transm Infect 2015; 91 135–41.
| Incidence of curable sexually transmissible infections among adolescents and young adults in remote Australian Aboriginal communities: analysis of longitudinal clinical service data.Crossref | GoogleScholarGoogle Scholar |
[3] Bowden FJ, Paterson BA, Mein J, Savage J, Fairley CK, Garland SM, Tabrizi SN. Estimating the prevalence of Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, and human papillomavirus infection in indigenous women in northern Australia. Sex Transm Infect 1999; 75 431–4.
| Estimating the prevalence of Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, and human papillomavirus infection in indigenous women in northern Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c3hslOmtg%3D%3D&md5=e53b218e409f5867221ab33c99b8be5eCAS |
[4] Roberts-Witteveen A, Pennington K, Higgins N, Lang C, Lahra M, Waddell R, Kaldor J. Epidemiology of gonorrhoea notifications in Australia, 2007–12. Sex Health 2014; 11 324–31.
| Epidemiology of gonorrhoea notifications in Australia, 2007–12.Crossref | GoogleScholarGoogle Scholar |
[5] The Kirby Institute. Bloodborne viral and sexually transmitted infections in Aboriginal and Torres Strait Islander people: sSurveillance and Evaluation evaluation Reportreport. Sydney: The Kirby Institute, UNSW; 2014.
[6] Graham S, Guy RJ, Donovan B, McManus H, Su JY, El-Hayek C, Kwan KS, Dyda A, Wand HC, Ward JS. Epidemiology of chlamydia and gonorrhoea among Indigenous and non-Indigenous Australians, 2000–2009. Med J Aust 2012; 197 642–6.
| Epidemiology of chlamydia and gonorrhoea among Indigenous and non-Indigenous Australians, 2000–2009.Crossref | GoogleScholarGoogle Scholar |
[7] National Aboriginal Community Controlled Health Organisation, Royal Australian College of General Practitioners. National guide to a preventive health assessment for Aboriginal and Torres Strait Islander peoples, 2nd edn. Melbourne: The Royal Australian College of General Practitioners; 2012.
[8] Ressler KA, Ferson MJ, Smedley EJ. Gonorrhoea infection, reinfection and co-infection in men in inner Sydney: a population-based analysis. Med J Aust 2014; 200 26
| Gonorrhoea infection, reinfection and co-infection in men in inner Sydney: a population-based analysis.Crossref | GoogleScholarGoogle Scholar |
[9] Creighton S. Gonorrhoea. Systematic review 1604. BMJ Clin Evid 2014. Available online at: http://clinicalevidence.bmj.com/x/systematic-review/1604/overview.html [verified 29 March 2017].
[10] Donovan B, Dimech W, Ali H, Guy R, Hellard M. Increased testing for Neisseria gonorrhoeae with duplex nucleic acid amplification tests in Australia: implications for surveillance. Sex Health 2015; 12 48–50.
| Increased testing for Neisseria gonorrhoeae with duplex nucleic acid amplification tests in Australia: implications for surveillance.Crossref | GoogleScholarGoogle Scholar |
[11] Australian Bureau of Statistics. The Australian Statistical Geography Standard (ASGS) Remoteness Structure. Canberra: Australian Government; 2006. Available online at: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Previousproducts/1216.0Main%20Features1Jul%202006?opendocument&tabname=Summary&prodno=1216.0&issue=Jul%202006&num=&view [verified 12 December 2015].
[12] Boyle D, Kong F. A systematic mechanism for the ethical collection and interpretation of display format pathology test results from Australian Primary Care records e-J Health Informatics 2011; 6 e18
[13] Chow EP, Fehler G, Read TR, Tabrizi SN, Hocking JS, Denham I, Bradshaw CS, Chen MY, Fairley CK. Gonorrhoea notifications and nucleic acid amplification testing in a very low-prevalence Australian female population. Med J Aust 2015; 202 321–3.
| Gonorrhoea notifications and nucleic acid amplification testing in a very low-prevalence Australian female population.Crossref | GoogleScholarGoogle Scholar |
[14] McDonagh P, Ryder N, McNulty AM, Freedman E. Neisseria gonorrhoeae infection in urban Sydney women: prevalence and predictors. Sex Health 2009; 6 241–4.
| Neisseria gonorrhoeae infection in urban Sydney women: prevalence and predictors.Crossref | GoogleScholarGoogle Scholar |
[15] Sexual Health and Blood Borne Virus Unit Centre for Disease Control. NT Guidelines for the management of sexually transmitted infections in the primary care setting. Darwin: Northern Territory Government Department of Health; 2012.
[16] Sullivan Nicolaides Pathology. Partners in crime Chlamydia trachomatis and Neisseria gonorrhoeae 2012 [cited 2015 12 December]. Available fromonline at: http://www.snp.com.au/media/309124/syzygy_march_2012.pdf [verified 12 December 2015].
[17] Lahra MM, Australian Gonococcal Surveillance Programme Australian Gonococcal Surveillance Programme annual report, 2012. Commun Dis Intell Q Rep 2013; 37 E233–9.
[18] Ndowa F, Lusti-Narasimhan M. The threat of untreatable gonorrhoea: implications and consequences for reproductive and sexual morbidity. Reprod Health Matters 2012; 20 76–82.
| The threat of untreatable gonorrhoea: implications and consequences for reproductive and sexual morbidity.Crossref | GoogleScholarGoogle Scholar |
