Exploration of testing practices and population characteristics support an increase in chlamydia positivity in Tasmania between 2001 and 2010

Objective : The proportion of positive chlamydia tests in young people in Tasmania increased significantly between 2001 and 2010. While female positivity rates increased steadily, male positivity rose steeply to 2005 then stabilised. Crude positivity rates can be influenced by a variety of factors making interpretation difficult. Unique Tasmanian datasets were used to explore whether symptom status, reason for testing or sexual exposure could explain the observed positivity trends. Methods : Population‐level chlamydia positivity rates in Tasmania over a 10‐year period were compared with surveillance data collected on people aged 15 to 29 years notified with chlamydia. Results : The proportion of asymptomatic chlamydia cases increased, with the largest increase in males aged 15 to 19 years (28%). Opportunistic testing of cases increased (greatest in males, range 17–32%). Sexual exposure remained consistent. Conclusions : After allowing for any changes in sexual exposure, symptom status and reason for testing, an increase in chlamydia positivity occurred over the 10 years. Healthcare providers have increased chlamydia testing in high‐risk groups. Implications : Monitoring chlamydia testing patterns and positivity rates at a population level is a step forward in surveillance practices. Targeted surveys provide valuable information to supplement routine surveillance data.     

江苏省2005-2013年性病监测点3种性病流行病学特征分析

目的了解2005-2013年江苏省性病区域监测点尖锐湿疣、生殖器疱疹和生殖道沙眼衣原体感染等3种性病流行病学特征,为制定控制措施提供依据。方法收集2005-2013年江苏省6个性病区域监测点3种性病的病例报告资料,采用描述性流行病学方法进行分析。结果 2005-2013年,尖锐湿疣、生殖器疱疹、生殖道沙眼衣原体感染年均发病率分别为5.51/10万、0.7/10万、1.91/10万。尖锐湿疣和生殖器疱疹发病以男性为主,生殖道沙眼衣原体感染报告病例以女性为主。3种性病高发年龄均集中在20~49岁组,工人、农民和民工分别占各性病总数的63.69%、61.93%、46.85%。结论江苏省性病区域监测点3种重点性病发病情况不容乐观,应加强防控工作。     

Australia's notifiable diseases status, 2000. Annual report of the National Notifiable Diseases Surveillance System.

In 2000, there were 89,740 notifications of communicable diseases in Australia collected by the National Notifiable Diseases Surveillance System (NNDSS). The number of notifications in 2000 was an increase of 5.9 per cent over those reported in 1999 (84,743) and the largest reporting year since the NNDSS commenced in 1991. Notifications in 2000 consisted of 28,341 bloodborne infections (32% of total), 24,319 sexually transmitted infections (27%), 21,303 gastrointestinal infections (24%), 6,617 vaccine preventable infections (7%), 6,069 vectorborne infections (7%), 2,121 other bacterial infections (legionellosis, meningococcal infection, leprosy and tuberculosis) (2%), 969 zoonotic infections (1%) and only one case of a quarantinable infection. Steep declines in some childhood vaccine preventable diseases such as Haemophilus influenzae type b, measles, mumps and rubella, continued in 2000. In contrast, notifications of pertussis and legionellosis increased sharply in the year. Notifications of bloodborne viral diseases (particularly hepatitis B and hepatitis C) and some sexually transmitted infections such as chlamydia, continue to increase in Australia. This report also summarises data on communicable diseases from other surveillance systems including the Laboratory Virology and Serology Surveillance Scheme (LabVISE) and sentinel general practitioner schemes. In addition this report comments on other important developments in communicable disease control in Australia in 2000.     

Australia's notifiable diseases status, 1999: annual report of the National Notifiable Diseases Surveillance System.

In 1999 there were 88,229 [corrected] notifications of communicable diseases in Australia reported to the National Notifiable Diseases Surveillance System (NNDSS). The number of notifications in 1999 was an increase of 3 per cent on notifications in 1998 (85,227) and the second largest reporting year since the NNDSS commenced in 1991. Notifications in 1999 consisted of 29,977 bloodborne infections (34% of total), 22,255 gastrointestinal infections (25%), 21,704 sexually transmitted infections (25%), 5,986 vector borne infections (7%),5,228 vaccine preventable infections (6%), 1,967 (2%) other bacterial infections (legionella, meningococcal, leprosy and tuberculosis), 1,012 zoonotic infections (1%) and 3 quarantinable infections (0.003%). Notifications of bloodborne viral diseases particularly hepatitis B and hepatitis C and some sexually transmitted infections such as gonorrhoea and chlamydia continue to increase in Australia. Steep declines in vaccine preventable diseases such as Haemophilus influenzae type b, measles, mumps and rubella continued in 1999. This report also summarises data on communicable diseases from other surveillance systems including the Laboratory Virology and Serology Surveillance Scheme (LabVISE) and sentinel general practitioner schemes. In addition this report comments on other important developments in communicable disease control in Australia in 1999.     

Patterns of Sexual Practices,Sexually Transmitted Infections and Other Genital Infections in Women Who Have Sex with Women Only (WSWO), Women Who Have Sex with Men Only (WSMO) and Women Who Have Sex with Men and Women (WSMW): Findings from a Sexual Health Clinic in Melbourne,Australia, 2011–2019

Archives of Sexual Behavior - Despite rises in sexually transmitted infection (STI) notifications among Australian women in the last decade, limited STI surveillance data exist specifically for...     

Chlamydia Screening and Positivity in Juvenile Detention Centers,United States, 2009–2011

An estimated 2.9 million new chlamydia infections occur in the United States each year. Among women, chlamydia can lead to serious adverse outcomes, including pelvic inflammatory disease and infertility. Chlamydia prevalence is highest among females aged 15–19 years. Despite long-standing recommendations directed at young, sexually active females, screening remains sub-optimal. Juvenile detention centers (JDCs) are uniquely situated to screen and treat high-risk adolescents. From 2009–2011, performance measure data on chlamydia screening coverage (proportion of eligible females screened) and positivity (proportion of females tested who were positive) were available from 126 geographically-dispersed JDCs in the United States. These facilities reported screening 55.2% of females entering the facilities (149,923), with a facility-specific median of 66.4% (range: 0–100%). Almost half (44.4%) of facilities had screening coverage levels of 75–100%. This screening resulted in the detection of 12,305 chlamydial infections, for an overall positivity of 14.7% (facility-specific median = 14.9%, range: 0–36.9%). In linear regression analysis, chlamydia positivity was inversely associated with screening coverage: as coverage increased, positivity decreased. The burden of chlamydia in JDCs is substantial; facilities should continue to deliver recommended chlamydia screening and treatment to females and identify mechanisms to increase coverage.     

成都口岸2004～2009年出入境人员HIV感染状况监测与分析

目的了解成都口岸出入境人员HIV感染情况及流行病学特征,为加强口岸艾滋病防控工作提供信息。方法对2004～2009年四川国际旅行卫生保健中心监测的40例HIV感染者的流行病学资料进行统计学分析。结果成都口岸出入境人员2004～2009年共检出40例HIV感染者,检出率为0.33‰(0.06%～0.60%),年检出率呈上升趋势。其中39名男性,1名女性。75%为外派劳务人员;年龄以30～39岁为主;性接触传播为主要感染途径。结论成都口岸出入境人员HIV感染者以青壮年和外派劳务人员为主,呈逐年增加的趋势,表明口岸艾滋病防控工作应随之加强。     

Screening asymptomatic adolescent males for chlamydia

Ninety-seven asymptomatic 16–21-year-old sexually active adolescent males were evaluated for gonorrhea and chlamydia by culture, chlamydia enzyme immunoassay, and an analysis of a random urine sample for pyuria using centrifuged urine and urine cytometer. The incidence of gonorrhea was 5.3% and chlamydia by culture 12.3%. Immunoassay was superior in sensitivity and specificity (75% and 99%, respectively) to centrifuged urine (sensitivity 58%, specificity 92%) or urine cytometer (58% and 91%) in identifying asymptomatic chlamydia urethritis. Chlamydia enzyme immunoassay is an acceptable, more rapid, and less expensive alternative to culture. The absence of pyuria in asymptomatic males cannot be assumed to indicate the absence of a sexually transmitted disease.     

Chlamydia sentinel surveillance in Aboriginal Community Controlled Health Services finds higher testing and positivity rates among younger people

Objective: To measure chlamydia testing and positivity rates among 16–39 year olds attending Aboriginal Community Controlled Health Services (ACCHSs). Methods: Retrospective non‐identifiable computerised records containing consultation and chlamydia testing data were collected for patients (16–39 years) attending eight ACCHSs during 2008–09 in urban, regional and remote settings for the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) system. Annual chlamydia testing and positivity rates were estimated. Results: Over two years, 13,809 patients aged 16–39 years (57.8% female, 82.3% Aboriginal or Torres Strait Islander) attended. The annual overall chlamydia testing rate was 13.0% (2008) and 16.0% (2009). Testing rates were higher among females (p<0.001) and among patients aged 16–29 than 30–39 years (males: p=0.01; females: p<0.001). Chlamydia positivity was 8.5% overall; similar in females (8.7%) and males (7.8%) (p=0.46); highest among 16–19 years (females: 17.4%; males: 13.0%), declining to 1.5% among females 35–39 years (p<0.001) and 4.8% among males 30–34 years (p<0.001). Conclusions: Chlamydia testing at these ACCHSs approached recommended levels among some patient groups, however, it should increase. High positivity among younger people highlights they should be targeted. Implications: Young people should be targeted for sexual health interventions. ACCHSs are well placed to provide enhanced sexual health services if appropriately resourced.     

Tuberculosis among Pennsylvania migrant farm workers

The purpose of this study was to determine the tuberculin positivity rates and the incidence of sexually transmitted diseases (STDs) among a population of seasonal, nonmigrating farm workers. Participants were tested for tuberculosis (TB) sensitivity, syphilis, gonorrhea, and chlamydia. Patients were afforded follow-up even if they returned home to Mexico during the course of their treatment. We found that the TB rate (15%) and the incidence of STDs to be significantly lower than in other studies of migrant populations. We hypothesize that exposure to urban commercial sex workers who frequent many migrant camps may be involved in the transmission of TB. Further research is needed to determine the incidence of TB among commercial sex workers and the extent to which transmission occurs between these two populations. We also describe our follow-up program and recommend a closer adherence to the Centers for Disease Control and Prevention guidelines with respect to adequate health education and disease prevention.     

A new national Chlamydia Sentinel Surveillance System in Australia: evaluation of the first stage of implementation

The Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) was established with funding from the Department of Health and Ageing to trial the monitoring of the uptake and outcome of chlamydia testing in Australia. ACCESS involved 6 separate networks; 5 clinical networks involving sexual health services, family planning clinics, general practices, antenatal clinics, Aboriginal community controlled health services, and 1 laboratory network. The program ran from May 2007 to September 2010. An evaluation of ACCESS was undertaken in early 2010, 2 years after the program was funded. At the time of the evaluation, 76 of the 91 participating sites were contributing data. The jurisdictional distribution of the 76 sites generally matched the jurisdictional distribution of the Australian population. In 2008, the chlamydia testing rates in persons aged 16-29 years attending the 26 general practices was 4.2% in males and 7.0% in females. At the 25 sexual health services, the chlamydia testing rates in heterosexuals aged less than 25 years in 2008 was 77% in males and 74% in females. Between 2004 and 2008, the chlamydia positivity rate increased significantly in heterosexual females aged less than 25 years attending the sexual health services, from 11.5% to 14.1% (P < 0.01). Data completeness was above 85% for all core variables except Aboriginal and/or Torres Strait Islander status and country of birth, which ranged from 68%-100%, and 74%-100%, respectively, per network. There were delays in establishment of the system due to recruitment of 91 sites, multiple ethics applications and establishment of automated extraction programs in 10 different database systems, to transform clinic records into a common, pre-defined surveillance format. ACCESS has considerable potential as a mechanism toward supporting a better understanding of long-term trends in chlamydia notifications and to support policy and program delivery.     

性罪错人员性病感染情况的调查

目的:了解深圳市性罪错人员的性病感染情况。方法:对2 0 0 2年深圳市某收教所的1 3 87名性罪错人员进行体检以及性病实验室检测,并收集相关资料作流行病学分析。结果:在1 3 87名被检测者中,共检出1 86名学员感染性病,检出率为1 3.5 %。其中HIV感染者4例,男、女学员各2例。女学员性病检出率明显高于男学员。结论:性罪错人员是性病的重要传染源,加强对性罪错人员的性病流行病学监测是预防和控制性病流行的有效措施之一     

Understanding sexual risk taking behaviour in Hong Kong university students. A health promotion perspective

BACKGROUND: Levels of sexual experience among Chinese university students are considerably lower than in western countries. Measuring sexual risk-taking behavior of Chinese students is important in designing any effective preventive health programs. This study assessed the prevalence and factors associated with high-risk sexual behavior among students in a Hong Kong university. METHODS: A cross-sectional survey conducted among year 1 and year 3 Chinese undergraduate students in 1997, using a structured, self-administered questionnaire. RESULTS: Of the 1197 students surveyed, only 11% were sexually active (ever had sexual intercourse). Reported sexual activity was higher among year 3 (17%) than year 1 (6.6%) students and higher among males (14.4%) than females (8.3%). Consistent (always) use of condoms was reported by only 43% of the sexually active respondents. Males were more likely to think that premarital sex was acceptable than were females. About 1 in 20 students (55 of 1197) were categorized as belonging to a "greater risk behavior" group, defined by inconsistent or nonuse of condoms during sexual intercourse and having had three or more sexual partners in the past 3 months, or having has sex with prostitutes or ever having a sexually transmitted disease, or using alcohol or other stimulating drugs during sexual intercourse. Males with favorable attitudes toward premarital sex were more likely to belong to the greater risk behavior group. CONCLUSIONS: This study demonstrated the potential risk for contracting sexually transmitted diseases among a substantial proportion of university students, suggesting the need for promotion of preventive education programs.     

云南河口县越南跨境女性性工作者性传播感染和求医行为状况

目的了解云南河口县越南跨境女性性工作者(FSW)人群性传播感染状况、求医行为及其影响因素,为促进越南跨境FSW生殖健康和预防控制性病传播提供依据。方法采用“滚雪球”方式在云南河口县娱乐场所招募研究对象,进行问卷调查并采集血液、阴道分泌物和取宫颈拭子标本进行HIV/性病检测。结果共调查262名越南跨境FSW,94人被检出感染性病和艾滋病,感染率为35.88%。近一年116名(44.27%)越南跨境FSW出现性病相关症状,其中34.45%出现症状后选择去医院或私人门诊就诊,44.83%自行买药治疗,20.69%未做任何治疗。在过去一年进行过性病检测(OR=3.54,P<0.05),来自中高档场所(OR=3.94,P<0.05),出现两种以上性病相关症状(OR=3.88,P<0.05),自认为感染性病高风险(OR=3.03,P<0.05)的FSW更可能去医院或私人门诊就诊。结论云南河口县越南跨境FSW人群有较高的性病感染率,出现性病相关症状去医院门诊就诊率较低,未做任何治疗比例较高,需要正确引导越南跨境FSW的求医行为。     

Mumps and rubella surveillance in Victoria, 1993 to 2000.

Despite improving childhood coverage of the measles-mumps-rubella vaccine (MMR) in Victoria during the 1990s, mumps and rubella notifications in age groups eligible for vaccination persisted. This study reviewed the mumps and rubella surveillance data from 1993 to 2000 with a specific focus on method of diagnosis. There were 474 notifications of mumps over the seven-year period (annual median 61, range 40 to 77) and 3,544 notifications of rubella (annual median 297, range 66 to 1,165). The highest notifications rates for mumps were consistently among the 1-4 and 5-9 year age groups, whereas there was a marked change in the age distribution of rubella notifications during this interval. A large rubella outbreak occurred in 1995 with 1,165 notifications; the highest notification rates were males aged 15-24 years, infants under one year of age (males and females), and those aged 5-14 years (males and females), respectively. The susceptibility of 5-24 year olds reflects historical changes to the Australian Standard Vaccination Schedule. Rubella notifications returned to baseline levels in 1998 with the highest notification rates in infants aged under one year, and children aged 1-4 years. For both mumps and rubella, the majority of notifications for all age groups were clinically diagnosed, and were most common in children.     

The knowledge,education and behaviour of young people with regard to Chlamydia trachomatis in Aarhus,Denmark and Bonn,Germany: Do prevention concepts matter?

Young people are at high risk of sexually transmitted infections, especially Chlamydia trachomatis, the most prevalent bacterial sexually transmitted disease in the developed world. Young people lack knowledge about sexually transmitted diseases (STDs) and are more aware of the risks of unwanted pregnancy than their risk of acquiring a STD. Different STD prevention concepts in different countries focus on different STDs. Based on explorative data analysis (Categorical Principal Component Analysis, CatPCA) this study, conducted in 2005, investigates the associations between self-estimation of sexual knowledge, active knowledge of chlamydia and HIV/AIDS, differing sex education and the sexual behaviour of 15–19 year old pupils from Aarhus, Denmark (N = 97), and Bonn, Germany (N = 93). A constructed knowledge, education and behaviour space model shows interesting associations between active STD knowledge and the sex education provided by both media and professionals. Sexual behaviour depends especially on sex education acquired through TV, Internet and print media. The young people from Aarhus and Bonn have significantly differing knowledge levels of chlamydia and HIV/AIDS. This is understood to be an effect of the different STD prevention concepts in Denmark and Germany.     

Prevalence and Predictors of Sexually Transmitted Infections in Hazardously-Drinking Incarcerated Women

Incarcerated women are at high risk for sexually transmitted infections. Left untreated, these infections can have severe adverse health effects. In this study the authors present prevalence rates of trichomonas, chlamydia, and gonorrhea, and factors related to having a sexually transmitted infection in a sample of 245 hazardously-drinking incarcerated women who reported heterosexual intercourse in the previous 3 months. Vaginal swabs were collected following the self-report baseline assessment. Participants averaged 34.0 (±8.8) years of age; 174 (71.3%) were non-Hispanic Caucasian, 47 (19.3%) were African-American, 17 (7.0%) were Hispanic, and 6 (2.5%) were of other racial or ethnic origins. Twenty-three percent of participants tested positive for chlamydia, trichomonas, or gonorrhea. Being African-American, more frequent sex with a casual partner, and reporting more than one male partner were significantly positively related to sexually transmitted infection, while more frequent sex with a main partner was inversely related. Due to the high rates of infection in this population, jail admission provides a public health opportunity to access a concentrated group of sexually transmitted infectious women. Sexually transmitted infection testing targeted at specific demographic factors, for instance younger age, will miss infected women. Risky sexual partnerships, as well as the benefit of maintaining stable main partnerships may be important topics during sexually transmitted infection prevention interventions.     

Prevalence and predictors of sexually transmitted infections in hazardously-drinking incarcerated women

Incarcerated women are at high risk for sexually transmitted infections. Left untreated, these infections can have severe adverse health effects. In this study the authors present prevalence rates of trichomonas, chlamydia, and gonorrhea, and factors related to having a sexually transmitted infection in a sample of 245 hazardously-drinking incarcerated women who reported heterosexual intercourse in the previous 3 months. Vaginal swabs were collected following the self-report baseline assessment. Participants averaged 34.0 (±8.8) years of age; 174 (71.3%) were non-Hispanic Caucasian, 47 (19.3%) were African-American, 17 (7.0%) were Hispanic, and 6 (2.5%) were of other racial or ethnic origins. Twenty-three percent of participants tested positive for chlamydia, trichomonas, or gonorrhea. Being African-American, more frequent sex with a casual partner, and reporting more than one male partner were significantly positively related to sexually transmitted infection, while more frequent sex with a main partner was inversely related. Due to the high rates of infection in this population, jail admission provides a public health opportunity to access a concentrated group of sexually transmitted infectious women. Sexually transmitted infection testing targeted at specific demographic factors, for instance younger age, will miss infected women. Risky sexual partnerships, as well as the benefit of maintaining stable main partnerships may be important topics during sexually transmitted infection prevention interventions.     

Evaluating measles surveillance using laboratory-discarded notifications of measles-like illness during elimination

For jurisdictions implementing measles elimination strategies, a minimum surveillance benchmark of 1/100 000 population per year measles-like illness (MLI) cases initially notified, but then rejected based on laboratory testing was proposed. We used this standard to assess the quality of the Victorian enhanced measles surveillance between 1998 and 2003. Victorian enhanced measles surveillance includes interviews with notified cases and confirmatory laboratory testing for notifications. We found 72% (918/1281) of measles notifications were discarded after testing. The median annual rate of discard was 2.9/100 000. The annual discard rate was inversely associated with the age of the notifications, and measles negative with no other diagnosis made was the most common laboratory outcome. The annual rates of discarded notifications in Victoria were consistently above the minimum recommended standard. The rate of discarded MLIs as a surveillance threshold should be useful in measles endemic regions, but may require modification where disease elimination has occurred.