A brief picture of gonorrhoea in New Zealand
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A brief picture of gonorrhoea in New Zealand

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A brief picture of gonorrhoea in New Zealand A brief picture of gonorrhoea in New Zealand Presentation Transcript

  • A brief picture of gonorrhoea in New Zealand Kerry Sexton, Public Health Physician, ESRNZSHS conference 2012, gonorrhoea workshop, 30 August 2012 Specialist Science Solutions Manaaki Tangata Taiao Hoki protecting people and their environment through science
  • Outline • National burden of gonorrhoea  Historical  Recent trends • Demographic distribution of cases • Other risk factors for gonorrhoea • Testing for gonorrhoea  Testing rates and test positivity • Not going to discuss:  NAAT testing for gonorrhoea  Antimicrobial resistance© ESR 2012
  • National burden of gonorrhoea 1976 (lab data) 208 per 100,000 6482 cases Platts, W. M. (1979). "Epidemiology of gonorrhoea and syphilis in New Zealand." Br J Vener Dis 55: 138-141.© ESR 2012
  • National burden of gonorrhoea cont...Lyttle, P. H. (1994). "Surveillance report: disease trends at New Zealand sexually transmitted disease clinics 1977-1993."Genitourin Med 70: 329-335.© ESR 2012
  • Gonorrhoea rates in selected DHBs, 1998-2011© ESR 2012
  • Estimated national gonorrhoea rate, 2008-2011 67 = NZ rate 2011 44 = Australia 2010 M:F ratio 2011: 1.4 30 = UK 2010 101 = US 2010© ESR 2012
  • Gonorrhoea rates by age group and sex, 2008-2011 Females Males 450Cases per 100 000 female population 400 350 300 250 200 150 100 50 0 2008 2009 2010 2011 Year © ESR 2012
  • Gonorrhoea rates by ethnicity© ESR 2012
  • Age standardised gonorrhoea incidence rates by ethnicity and sex, Bay of Plenty, 2003 to 2007© ESR 2012
  • Gonorrhoea rates by DHB, 2011© ESR 2012
  • Other risk/protective factors • Greater number of sexual contacts - Auckland SHS case-control study1 - Cases of gonorrhoea reported more sexual contacts in the preceding 3 months than did controls (p=0.05) • MSM - Gay Auckland Periodic Sex Survey2 - 3.3% reported gonorrhoea in last 12 months - 17.3% reported a diagnosis of gonorrhoea in their lifetime • Condom use - Auckland SHS case-control study1 - Consistent condom use was found to lower the risk of gonorrhoea (p=0.009)1Azariah and Perkins (2007). Risk factors and characteristics of patients with gonorrhoea presenting to Auckland Sexual Health Service,New Zealand. NZMJ 120(1252):2491.2Saxton, Dickson and Hughes (2006). GAPSS 2006: Findings from the Gay Auckland Periodic Sex Survey. Auckland: New ZealandAIDS Foundation. © ESR 2012
  • Site of infection, non-urogenital gonorrhoea cases in SHCs, males, 2006-2011 anorectal epididymitis pharynx other site 60 80-90% Number of cases 50 urogenital 40 30 20 10 0 2006 2007 2008 2009 2010 2011 Year© ESR 2012
  • Relative gonorrhoea testing volumes, selected DHBs, 2002-2011© ESR 2012
  • Gonorrhoea incidence & testing rates by age group, females, BOP,2003-2007 Incidence Testing rates © ESR 2012
  • Gonorrhoea incidence & testing rates by TA, Bay of Plenty, 2003 to 2007 © ESR 2012
  • Summary • National gonorrhoea burden peaked in the 1970s, smaller peak 2006 • Estimated national rate stable over last 4 years, 67 per 100,000 in 2011 • Highest risk groups: 15-24y olds and Māori and Pacific, MSM • Tairawhiti DHB rate 5x national rate • Increasing anorectal and pharyngeal positives • Testing mismatch versus incidence© ESR 2012
  • © ESR 2012
  • © ESR 2012
  • Gonorrhoea testing rates/test positivity by TA, Bay of Plenty, 2003 to 2007 © ESR 2012
  • Platts, W. M. (1979). "Epidemiology of gonorrhoea and syphilis in New Zealand." Br J Vener Dis 55: 138-141.© ESR 2012
  • Gonorrhoea Prevalence • MSM, phone survey, 1996 • Any gonorrhoea 16.8% (penile 13.6%, anal 4.4%, oral 3.0%; signif higher in those HIV positive) Dunedin cohort • Gonorrhoea 1 (2.6) 5 (5.6) 1 (1.4) 0 (0 • Gonorrhoea up to 21 Male 1 (2.6) Female 5 (5.6) 21 to 26 Male 1 (1.4) Female 0 (0.0) 26 to 32 Male 0 (0.0) Female 0 (0.0)Saxton, Hughes and Robinson (2002). "Sexually transmitted diseases and hepatitis in a national sample of men who havesex with men in New Zealand." NZMJ 115(1158). © ESR 2012
  • Gonorrhoea rates by DHB, 2007 to 2011 2007 2008 2009 2010 2011 400 350 300 Rate per 100 000 population 250 200 150 100 50 ** ** 0 Auckland region Wairarapa West Coast Southern Whanganui Taranaki² Northland¹ Waikato Wellington region Tairawhiti MidCentral Lakes Bay of Plenty Hawkes Bay District Health Board Note: Additional labs began reporting in 2010 in Northland and 2011 in Taranaki© ESR 2012