Gonococcal infections and risk factors for reinfection: a descriptive and case-case analysis of notifications in the Australian Capital Territory, 2017–2022
DOI:
https://doi.org/10.33321/cdi.2024.48.51Keywords:
sexually transmissible infection, gonococcal infection, reinfection, risk factor, notifications, Australian Capital TerritoryAbstract
Background
In Australia, gonococcal infection notification rates are increasing with reinfections representing a substantial proportion of infections. Understanding the local epidemiology of gonococcal infections and reinfections and the risk factors for reinfection can assist with the design of targeted interventions. This study aimed to describe the epidemiology of gonococcal infections and reinfections between 2017 and 2022 in the Australian Capital Territory (ACT), and examine the risk factors for reinfection.
Methods
Data for gonococcal infections notified in the ACT between 2017 and 2022 were described. The epidemiological characteristics of individuals with a single infection and reinfection were compared using a case-case study design.
Results
There were 1,886 gonococcal infection notifications during the study period. Of these, 20.4% were reinfections (n = 385). Of 1,501 individuals, 1,254 (83.5%) had a single infection and 247 (16.5%) had a reinfection. Between 2017 and 2022, the annual gonococcal infection notification rate per 100,000 population increased from 59.98 to 80.14 and the proportion of reinfections from 4.0% to 26.8%.
Downloads
References
World Health Organization (WHO). Global health sector strategy on Sexually Transmitted Infections, 2016–2021. Geneva: WHO, Sexual and Reproductive Health and Research team; 3 October 2016. [Accessed on 22 June 2023.] Available from: https://www.who.int/publications/i/item/WHO-RHR-16.09.
Centers for Disease Control and Prevention (CDC). Antimicrobial-Resistant Gonorrhea Basic Information. [Webpage.] Atlanta: United States Department of Health and Human Services, CDC, National Center for HIV, Viral Hepatitis, STD, and TB Prevention; 28 December 2022. [Accessed on 14 June 2023.] Available from: https://www.cdc.gov/std/gonorrhea/drug-resistant/basic.htm.
Gradison M. Pelvic inflammatory disease. Am Fam Physician. 2012;85(8):791–6. Available from: https://www.aafp.org/pubs/afp/issues/2012/0415/p791.pdf.
Vallely LM, Egli-Gany D, Wand H, Pomat WS, Homer CS, Guy R et al. Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae: systematic review and meta-analysis. Sex Transm Infect. 2021;97(2):104–111. doi: https://doi.org/10.1136/sextrans-2020-054653.
Guvenc F, Kaul R, Gray-Owen SD. Intimate relations: molecular and immunologic interactions between Neisseria gonorrhoeae and HIV-1. Front Microbiol. 2020;11:1299. doi: https://doi.org/10.3389/fmicb.2020.01299.
Feily A, Namazi MR. Increasing HIV infectivity by Neisseria gonorrhea: role of host antiapoptotic proteins in enhanced transmission. AIDS. 2010;24(8):1237. doi: https://doi.org/10.1097/QAD.0b013e3283389141.
Communicable Diseases Network Australia (CDNA). Gonococcal infection – Surveillance case definition. Canberra: Australian Government Department of Health and Aged Care, CDNA; 5 January 2023. [Accessed on 14 June 2023.] Available from: https://www.health.gov.au/resources/publications/gonococcal-infection-surveillance-case-definition.
Public Health Laboratory Network (PHLN). Gonococcal infection – Laboratory case definition. Canberra: Australian Government Department of Health and Aged Care, CDNA; 2022. [Accessed on 14 June 2023.] Available from: https://www.health.gov.au/resources/publications/gonococcal-infection-laboratory-case-definition.
The Kirby Institute. Detailed sexually transmissible infections dashboards: Latest data. [Webpage.] Sydney: University of New South Wales, Kirby Institute; 2023. [Accessed on 24 June 2023.] Available from: https://data.kirby.unsw.edu.au/STIs.
King J, McManus H, Kwon JA, Gray R, McGregor S, Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2022. Sydney: University of New South Wales, Kirby Institute; 2022. [Accessed on 22 June 2023.] Available from: https://www.kirby.unsw.edu.au/sites/default/files/documents/Annual-Surveillance-Report-2022_STI.pdf.
Australian Government Department of Health and Aged Care. Fourth National Sexually Transmissible Infections Strategy 2018-2022. Canberra: Australian Government Department of Health and Aged Care; 12 July 2019. [Accessed on 23 June 2023.] Available from: https://www.health.gov.au/resources/publications/fourth-national-sexually-transmissible-infections-strategy-2018-2022.
Ong J, Bourne C, Dean J, Ryder N, Cornelisse V, Murray S et al. Australian sexually transmitted infection (STI) management guidelines for use in primary care 2022 update. Sex Health. 2023;20(1):1–8. doi: https://doi.org/10.1071/SH22134.
Australasian Society for HIV, Viral Hepatitis, and Sexual Health Medicine (ASHM). National PrEP Guidelines Update. Prevent HIV by Prescribing PrEP. [Webpage.] Sydney: ASHM; 2021. [Accessed on 12 June 2023.] Available from: https://ashm.org.au/resources/australian-prep-guidelines/.
Trecker MA, Dillon JA, Lloyd K, Hennink M, Waldner CL. Demographic and behavioural characteristics predict bacterial STI reinfection and coinfection among a cross-sectional sample of laboratory-confirmed gonorrhea cases in a local health region from Saskatchewan, Canada. Can J Public Health. 2015;106(2):e17–21. doi: https://doi.org/10.17269/rcsp.106.4792.
Ellis SL, Tsourtos G, Waddell R, Woodman R, Miller ER. Changing epidemiology of gonorrhea in Adelaide, South Australia. Sex Transm Dis. 2020;47(6):402–8. doi: https://doi.org/10.1097/OLQ.0000000000001162.
Meesaeng M, Sakboonyarat B, Thaiwat S. Incidence and risk factors of gonococcal urethritis reinfection among Thai male patients in a multicenter, retrospective cohort study. Sci Rep. 2021;11(1):22992. doi: https://doi.org/10.1038/s41598-021-02398-6.
Bautista CT, Wurapa EK, Sateren WB, Morris SM, Hollingsworth BP, Sanchez JL. Repeat infection with Neisseria gonorrhoeae among active duty U.S. Army personnel: a population-based case-series study. Int J STD AIDS. 2017;28(10):962–8. doi: https://doi.org/10.1177/0956462416681940.
Hughes G, Nichols T, Peters L, Bell G, Leong G, Kinghorn G. Repeat infection with gonorrhoea in Sheffield, UK: predictable and preventable? Sex Transm Infect. 2013;89(1):38–44. doi: https://doi.org/10.1136/sextrans-2012-050495.
Trecker MA, Dillon JAR, Lloyd K, Hennink M, Jolly A, Waldner C. Can social network analysis help address the high rates of bacterial sexually transmitted infections in Saskatchewan? Sex Transm Dis. 2017;44(6):338–43. doi: https://doi.org/10.1097/OLQ.0000000000000599.
Kenyon C, Buyze J, Klebanoff M, Brotman RM. The role of sexual networks in studies of how BV and STIs increase the risk of subsequent reinfection. Epidemiol Infect. 2018;146(15):2003–9. doi: https://doi.org/10.1017/S0950268818002157.
Australian Bureau of Statistics. National, state and territory population: reference period September 2022. [Webpage.] Canberra: Australian Bureau of Statistics; 16 March 2023. [Accessed on 14 June 2023.] Available from: https://www.abs.gov.au/statistics/people/population/national-state-and-territory-population/sep-2022.
Roberts-Witteveen A, Pennington K, Higgins N, Lang C, Lahra M, Waddell R et al. Epidemiology of gonorrhoea notifications in Australia, 2007–12. Sex Health. 2014;11(4):324–31. doi: https://doi.org/10.1071/SH13205.
Traeger MW, Cornelisse VJ, Asselin J, Price B, Roth NJ, Willcox J et al. Association of HIV preexposure prophylaxis with incidence of sexually transmitted infections among individuals at high risk of HIV infection. JAMA. 2019;321(14):1380–90. doi: https://doi.org/10.1001/jama.2019.2947.
Jansen K, Steffen G, Potthoff A, Schuppe AK, Beer D, Jessen H et al. STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany. BMC Infect Dis. 2020;20(1):110. doi: https://doi.org/10.1186/s12879-020-4831-4.
López de Munain J, Cámara-Pérez MDM, López Martinez M, Alava Menica JA, Hernandez Ragpa L, Imaz Pérez M et al. Alarming incidence of reinfections after treatment for Chlamydia trachomatis and gonorrhoea: can we predict and prevent them? Enferm Infecc Microbiol Clin (Engl Ed). 2023;41(5):269–77. doi: https://doi.org/10.1016/j.eimce.2021.10.010.
The Kirby Institute. Monitoring HIV pre-exposure prophylaxis uptake in Australia. Issue #8, May 2023. Sydney: University of New South Wales, Kirby Institute; May 2023. [Accessed on 9 July 2023.] Available from: https://www.kirby.unsw.edu.au/research/reports/monitoring-hiv-pre-exposure-prophylaxis-prep-uptake-australia-issue-8.
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2024 Communicable Diseases Intelligence
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
