Epidemiology of sexually transmissible infections in New South Wales: are case notifications enough?
DOI:
https://doi.org/10.33321/cdi.2013.37.52Keywords:
sexually transmissible infections, surveillance, hospitalisation, notifications, New South WalesAbstract
Background: Surveillance of sexually transmissible infections (STI)s is important to assess the disease burden in the population and to monitor and evaluate changes in trends over time. Routinely collected surveillance data in New South Wales are reliant on case reporting, which for many infections is an inadequate mechanism for capturing incidence and prevalence. Increasing rates of chlamydia over the past decade have sparked intense debate as to whether the current notification system is optimal and whether the true burden of infection are being measured. This study describes the current surveillance for STIs in New South Wales.
Methods: New South Wales-specific data for the years 2000–2009 were analysed. Notification data were used to examine the rate of the 4 STIs that are notifiable in New South Wales; chlamydia, gonorrhoea, infectious syphilis and HIV notifications. Hospital admissions and chlamydia-associated pelvic inflammatory disease were analysed using admitted patient data.
Results: Chlamydia was the most frequently reported of the notifiable STIs in New South Wales. Despite the higher rates of notification compared with other STIs, chlamydia-related hospitalisations contribute less than a 5th of all STI-related hospital admissions. Infectious syphilis contributed to the highest proportion of all STI-related hospitalisations in New South Wales and rates increased from 2000 to 2009. For other STIs such as anogenital herpes and gonorrhoea, hospital admissions remained stable for the same period.
Conclusions: Notifications data for STIs should be complemented with hospital admission and other data sources to better describe STI morbidity. A synthesis of these data sources is needed to improve current surveillance and allow for better comparisons and trend analysis of STIs in New South Wales. Commun Dis Intell 2013;37(4):E407–E414.
Downloads
References
World Health Organization. Estimation of the incidence and prevalence of sexually transmitted infections. Report of a WHO consultation 2002. Geneva; World Health Organization: 2002.
Donovan B, Franklin N, Guy R, Grulich AE, Regan DG, Ali H, et al. Quadrivalent human papillomavirus vaccination and trends in genital warts in Australia: analysis of national sentinel surveillance data. Lancet Infect Dis 2011;11(1):39–44.
Kang M, Rochford A, Skinner SR, Mindel A, Webb M, Peat J, et al. Sexual behaviour, sexually transmitted infections and attitudes to chlamydia testing among a unique national sample of young Australians: baseline data from a randomised controlled trial. BMC Public Health 2014;8(14):12.
Cunningham AL, Taylor R, Taylor J, Marks C, Shaw J, Mindel A. Prevalence of infection with herpes simplex virus types 1 and 2 in Australia: a nationwide population based survey. Sex Transm Infect 2006;82(2):164–168.
Lee E, Holt M, Mao L, McKenzie T, Batrouney C, Kennedy M, et al. Gay Community Periodic Survey: Melbourne 2011. Sydney: National Centre in HIV Social Research, The University of New South Wales; 2011. Available from: http://nchsr.arts.unsw.edu.au/publications/
Jin F, Prestage GP, Mao L, Kippax SC, Pell CM, Donovan B, et al. Transmission of herpes simplex virus types 1 and 2 in a prospective cohort of HIV-negative gay men: the health in men study. J Infect Dis 2006;194(5):561–570.
Pirotta M, Stein AN, Conway EL, Harrison C, Britt H, Garland S. Genital warts incidence and healthcare resource utilisation in Australia. Sex Transm Infect 2010;86(3):181–186.
Brotherton JM, Heywood A, Heley S, The incidence of genital warts in Australian women prior to the national vaccination program. Sex Health 2009;6(3):178–184.
Chen MY, Fairley CK, Donovan B. Discordance between trends in chlamydia notifications and hospital admission rates for chlamydia related diseases in New South Wales, Australia. Sex Transm Infect 2005;81(4):318–322.
Britt H, Miller GC, Charles J, Valenti L, Fahridin S, Pan Y, et al. General practice in Australia, health priorities and policies, 1998 to 2008. Canberra: Australian Institute of Health and Welfare. Available from: http://www.aihw.gov.au/publication-detail/?id=6442468257
Ali H, Guy RJ, Fairley CK, Wand H, Chen MY, Dickson B, et al. Understanding trends in genital Chlamydia trachomatis can benefit from enhanced surveillance: findings from Australia. Sex Transm Infect 2012;88(7):552–557.
Reynolds R, Oakman T. Genital chlamydia in southern New South Wales: an ecological analysis of testing and notification patterns 2004–2008. Aust J Rural Health 2010;18(4):159–165.
Communicable Diseases Network Australia. National Blood-borne Virus and Sexually Transmissible Infections Surveillance and Monitoring Plan: 2010–2013. Accessed November 2011. Available from: http://www.health.gov.au/internet/publications/publishing.nsf/Content/ohp-bbvs-plan10-13-l~ohp-bbvs-plan10-13-l-1
Liu B, Donovan B, Parker J, Guy R, Hocking J, Kaldor JM, et al. Increasing chlamydia diagnoses but little change in hospitalisations for ectopic pregnancy and infertility among women in New South Wales from 2001 to 2008. Sexual Health 2012;9(4):355–359.
Doxanakis A, Hayes RD, Chen MY, Gurrin LC, Hocking J, Bradshaw CS, et al. Missing pelvic inflammatory disease? Substantial differences in the rate at which doctors diagnose PID. Sex Transm Infect 2008;84(7):518–523.
Ness RB, Smith KJ, Chang CC, Schisterman EF, Bass DC, et al. Prediction of pelvic inflammatory disease among young single sexually active women. Sex Transm Dis 2006;33:137–142.
Jin F, Prestage GP, Kippax SC, Pell CM, Donovan BJ, Kaldor JM, et al. Epidemic syphilis among homosexually active men in Sydney. Med J Aust 2005;183(4):179–183.
Guy R, Wand H, Holt M, Mao L, Wilson DP, Bourne C, et al. High annual syphilis testing rates among gay men in Australia, but insufficient retesting. Sex Transm Dis 2012;39(4):268–275.
Australian Gonococcal Surveillance Programme. Annual report of the Australian Gonococcal Surveillance Programme 2009. Commun Dis Intell 2010.34(2): 89–95.
Janier M, Lassau F, Casin I, Morel P. Pharyngeal gonorrhoea: the forgotten reservoir. Sex Transm Infect 2003;79(4):345.
McMillan A, Young H, Moyes A. Rectal gonorrhoea in homosexual men: source of infection. Int J STD AIDS 2000;11(5):284–287.
Britt HC, Miller GC. The BEACH study of general practice. Med J Aust 2000 17;173(2):63–64.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2013 Communicable Diseases Intelligence
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
