Trends in testing and notification for genital gonorrhoea in a northern Australian district, 2004–2008
Jiunn-Yih Su A B C and John R. Condon BA Centre for Disease Control, Department of Health, Darwin, NT 0810, Australia.
B Menzies School of Health Research, Charles Darwin University, Darwin, NT 0810, Australia.
C Corresponding author. Email: Jiunn-Yih.Su@nt.gov.au
Sexual Health 9(4) 384-388 https://doi.org/10.1071/SH11113
Submitted: 10 August 2011 Accepted: 7 February 2012 Published: 25 May 2012
Abstract
Background: The study aimed to examine the trends in notification and testing for genital gonorrhoea (Neisseria gonorrhoeae) in the Darwin Remote District of Northern Territory, Australia, between 2004 and 2008. Methods: Using laboratory testing data and notification data, we calculated the annual sex- and age-specific notification rates, testing rates and positivity rates, and examined their trends. A deterministic matching method was used to identify unique individuals tested in order to estimate the number of years out of five in which each individual was tested. The correlation between testing rates and notification rates was calculated. Results: The notification rates for the 15–24 year age group increased sharply from 2004 to 2005, and then trended downwards between 2005 and 2008, with a decrease of 48.2% in females and 59.9% in males. No evident trends were found in testing rates. The positivity rates for this age group decreased by 46.3% in females (from 8.9% to 4.8%), and by 70.4% in males (from 10.8% to 3.2%) between 2004 and 2008. Over 76% of the population in this age-group had been tested at least once during the study period. A moderate correlation was found between notification rates and testing rates in both sexes. Conclusions: There was a significant decreasing trend in the notification rate of gonorrhoea between 2005 and 2008, which was most probably due to a decrease in prevalence. This study demonstrates the importance and utility of population-level testing data in understanding the epidemiology of common bacterial sexually transmissible infections such as gonorrhoea.
Additional keywords: incidence, Indigenous population, Northern Territory, positivity rate, prevalence.
References
[1] National Centre in HIV Epidemiology and Clinical Research (NCHECR). HIV/AIDS, viral hepatitis & sexually transmissible infections in Australia. Annual surveillance report 2009. Sydney: NCHECR, University of New South Wales; 2009.[2] Northern Territory Department of Health and Families (NTDHF). Sexual health and blood borne virus unit surveillance update. Darwin: NTDHF; 2009.
[3] Northern Territory Department of Health and Families (NTDHF). Sexual health and blood borne virus unit surveillance update. Darwin: NTDHF; 2004.
[4] Skov SJ, Miller P, Hateley W, Bastian IB, Davis J, Tait PW. Urinary diagnosis of gonorrhoea and chlamydia in men in remote aboriginal communities. Med J Aust 1997; 166 466–71.
[5] Bowden FJ, Paterson BA, Mein J, Savage J, Fairley CK, Garland SM, et al 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=dddf0c2c823249e556de846931d9abb3CAS | 10754952PubMed |
[6] Lim MSC, Guy RJ, Hellard ME. A profile of HIV testing in Victoria, 1984 to 2004. Commun Dis Intell 2006; 30 366–72.
[7] Slater W, Sadler K, Cassell JA, Horner P, Low N. What can be gained from comprehensive disaggregate surveillance? The Avon Surveillance System for sexually transmitted infections. Sex Transm Infect 2007; 83 411–5.
| What can be gained from comprehensive disaggregate surveillance? The Avon Surveillance System for sexually transmitted infections.Crossref | GoogleScholarGoogle Scholar | 17344247PubMed |
[8] Dicker LW, Mosure DJ, Levine WC. Chlamydia positivity versus prevalence. What’s the difference? Sex Transm Dis 1998; 25 251–3.
| Chlamydia positivity versus prevalence. What’s the difference?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3kvVOhug%3D%3D&md5=40e7a3b60ed59b9c272e11f52e412d7bCAS | 9587176PubMed |
[9] Dicker LW, Mosure DJ, Levine WC, Black CM, Berman SM. Impact of switching laboratory tests on reported trends in Chlamydia trachomatis infections. Am J Epidemiol 2000; 151 430–5.
| 1:STN:280:DC%2BD3c7lvVWnuw%3D%3D&md5=bc5eee92a3322b94cd0ede7115af40afCAS | 10695602PubMed |
[10] Hocking J, Fairley C, Counahan M, Crofts N. The pattern of notification and testing for genital Chlamydia trachomatis infection in Victoria, 1998–2000: an ecological analysis. Aust N Z J Public Health 2003; 27 405–8.
| The pattern of notification and testing for genital Chlamydia trachomatis infection in Victoria, 1998–2000: an ecological analysis.Crossref | GoogleScholarGoogle Scholar | 14705302PubMed |
[11] Chen MY, Karvelas M, Sundararajan V, Hocking JS, Fairley CK. Evidence for the effectiveness of a chlamydia awareness campaign: increased population rates of chlamydia testing and detection. Int J STD AIDS 2007; 18 239–43.
| Evidence for the effectiveness of a chlamydia awareness campaign: increased population rates of chlamydia testing and detection.Crossref | GoogleScholarGoogle Scholar | 17509173PubMed |
[12] Chen MY, Fairley CK, Donovan B. Nowhere near the point of diminishing returns: correlations between chlamydia testing and notification rates in New South Wales. Aust N Z J Public Health 2005; 29 249–53.
| Nowhere near the point of diminishing returns: correlations between chlamydia testing and notification rates in New South Wales.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2MXitlWjsb4%3D&md5=9fb5ea65aff1b8c5464af5806de3b628CAS | 15991773PubMed |
[13] O’Rourke KM, Fairley CK, Samaranayake A, Collignon P, Hocking JS. Trends in chlamydia positivity over time among women in Melbourne Australia, 2003 to 2007. Sex Transm Dis 2009; 36 763–7.
| Trends in chlamydia positivity over time among women in Melbourne Australia, 2003 to 2007.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MjotVegtw%3D%3D&md5=537050bfdddb085fe062efa3bb8e7395CAS | 19801964PubMed |
[14] Fethers K, Marks C, Mindel A, Estcourt CS. Sexually transmitted infections and risk behaviours in women who have sex with women. Sex Transm Infect 2000; 76 345–9.
| Sexually transmitted infections and risk behaviours in women who have sex with women.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M7gsVahtg%3D%3D&md5=4368cb567babbcf13bd04aebe0cdcef3CAS | 11141849PubMed |
[15] Donovan B. Rising prevalence of genital Chlamydia trachomatis infection in heterosexual patients at the Sydney Sexual Health Centre, 1994 to 2000. Commun Dis Intell 2002; 26 51–5.
[16] Allen K, Guy R, Leslie D, Goller J, Medland N, Roth N, et al The rise of infectious syphilis in Victoria and the impact of enhanced clinical testing. Aust N Z J Public Health 2008; 32 38–42.
| The rise of infectious syphilis in Victoria and the impact of enhanced clinical testing.Crossref | GoogleScholarGoogle Scholar | 18290912PubMed |
[17] Health Gains and Planning. Northern Territory resident population estimates by age, sex, Indigenous status and health districts (1971–2008). Darwin: Northern Territory Department of Health and Families; 2009.
[18] Northern Territory Department of Health and Families (NTDHF). Sexual health and blood borne virus unit surveillance update . Darwin: NTDHF; 2005.
[19] Kildea S, Bowden FJ. Reproductive health, infertility and sexually transmitted infections in indigenous women in a remote community in the Northern Territory. Aust N Z J Public Health 2000; 24 382–6.
| Reproductive health, infertility and sexually transmitted infections in indigenous women in a remote community in the Northern Territory.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvlsVSqtg%3D%3D&md5=839e335c42a6ccae1787e3e81991beaaCAS | 11011464PubMed |
[20] Su J-Y, Skov S. An assessment of the effectiveness of the Tiwi Sexual Health Program 2002–2005. Aust N Z J Public Health 2008; 32 554–8.
| An assessment of the effectiveness of the Tiwi Sexual Health Program 2002–2005.Crossref | GoogleScholarGoogle Scholar | 19076748PubMed |
[21] Whiley DM, Buda PJ, Bayliss J, Cover L, Bates J, Sloots TP. A new confirmatory Neisseria gonorrhoeae real-time PCR assay targeting the porA pseudogene. Eur J Clin Microbiol Infect Dis 2004; 23 705–10.
| 1:CAS:528:DC%2BD2cXns1eqs7s%3D&md5=c0d483d049a7d131a4d0dd7c464f16b4CAS | 15248092PubMed |
[22] Lum G, Garland SM, Tabrizi S, Harnett G, Smith DW, Sloots TP, et al Supplemental testing is still required in Australia for samples positive for Neisseria gonorrhoeae by nucleic acid detection tests. J Clin Microbiol 2006; 44 4292–4.
| Supplemental testing is still required in Australia for samples positive for Neisseria gonorrhoeae by nucleic acid detection tests.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28nlsFWjtg%3D%3D&md5=14f63669892088f0be0a96d2d36d61caCAS | 17088373PubMed |