Changing Epidemiology of Gonorrhea in Adelaide, South Australia

Ellis SL, Tsourtos G, Waddell R, Woodman R, Miller ER.

Changing Epidemiology of Gonorrhea in Adelaide, South Australia.

Sex Transm Dis. 2020 Jun;47(6):402-408. doi: 10.1097/OLQ.0000000000001162.

Abstract

Background: Gonorrhea is a significant public health concern. The changing epidemiology of gonorrhea in Australia has highlighted the need for detailed examination of surveillance data to determine population groups at greatest risk for infection.

Methods: We analyzed deidentified gonorrhea notification data for the years 2012 to 2017, in Adelaide (N = 3680), calculating age-adjusted notification and antibiotic resistance rates. Age, gender, year, sexual orientation, and socioeconomic status were assessed for associations with gonorrhea notifications using negative binomial, log binomial and spatial autoregressive models. Maps were generated to examine spatial localization of gonorrhea rates in Adelaide.

Results: Gonorrhea notification rates in Adelaide increased annually, with a 153% adjusted increase in rates from 2012 to 2017, localized to specific areas and inversely associated with income levels. The increase in rates in 2016 and 2017 was associated with young heterosexuals from low income areas. Azithromycin-resistant notifications increased significantly in 2016 in young heterosexuals. Reinfections were significantly more likely in men who have sex with men than other population groups.

Conclusions: This study demonstrates the changing epidemiology of gonorrhea in Adelaide from a largely men who have sex with men profile toward an increase in young heterosexual gonorrhea. This could be seen as a harbinger for future increases in heterosexually transmitted HIV and other sexually transmitted infections in Australia.

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Sex and gender: modifiers of health, disease, and medicine

The Lancet, Volume 396, Issue 10250, 22–28 August 2020, Pages 565-582
Mauvais-Jarvis, F., et al

Clinicians can encounter sex and gender disparities in diagnostic and therapeutic responses. These disparities are noted in epidemiology, pathophysiology, clinical manifestations, disease progression, and response to treatment. This Review discusses the fundamental influences of sex and gender as modifiers of the major causes of death and morbidity. We articulate how the genetic, epigenetic, and hormonal influences of biological sex influence physiology and disease, and how the social constructs of gender affect the behaviour of the community, clinicians, and patients in the health-care system and interact with pathobiology. We aim to guide clinicians and researchers to consider sex and gender in their approach to diagnosis, prevention, and treatment of diseases as a necessary and fundamental step towards precision medicine, which will benefit men’s and women’s health.

 

Diagnosis and Management of Syphilis in Patients With HIV Co-infection

Khaw, C., Malden, C., Ratnayake, M. et al. Diagnosis and Management of Syphilis in Patients With HIV Co-infectionCurr Treat Options Infect Dis (2020). https://doi.org/10.1007/s40506-020-00225-6

Published

Purpose of review

Syphilis cases are on the increase especially in men who have sex with men (MSM) in urban areas of high-income countries.

There is a strong association between syphilis and HIV infections.

We review the more recent literature regarding the epidemiology, clinical manifestations, diagnostic investigations, treatment and follow-up of syphilis in HIV infection.

  • Read abstract here (For full text access you can purchase from the publisher or see your librarian)

Webinar: Syphilis Outbreak in the Indigenous Community

SHINE SA, posted May 14, 2020

This free education session is presented by Adelaide Sexual Health Centre and will provide an update on syphilis.

General practitioners, nurses and/or midwives, Aboriginal Health Practitioners and Aboriginal Health Workers are encouraged to register for this training.

COURSE DETAILS

Date: 16 June 2020
Time: 7:00pm – 9:00pm

The webinar will cover:

  • Update on epidemiology
  • Review of diagnosis, staging and management of syphilis cases
  • How to interpret syphilis serology
  • Syphilis in pregnancy
  • Approaches to Partner Notification
  • Introduction to the South Australian Syphilis Register

Presenters:
Dr Alison Ward, Senior Consultant Sexual Health Physician
Njirrah Rowe, Aboriginal STI Education Coordinator and Partner Notification Officer

This activity is pending RACGP approval for 4 CPD activity points

This session is part of the Syphilis Outbreak Response and is a partnership between SHINE SA and Adelaide Sexual Health Centre.

No cost to attend.

New COVID Taskforce website from ASHM

ASHM, UPDATED ON: 14 April 2020

ASHM’s Taskforce on BBVs, Sexual Health and COVID-19 was established on 20 March 2020. It provides a timely opportunity for the BBV and sexual health sectors to discuss the scientific, clinical, BBV and sexual health service delivery and social implications of COVID-19, and provides consistent and evidence-based messaging to the health workforce, sector partners and community.

The website contains interim recommendations on:

  • adults living with HIV
  • adults living with chronic hepatitis B.
  • adults living with hepatitis C, or the complications of previous hepatitis C infection
  • people who are incarcerated in criminal justice settings during the COVID-19 pandemic including those who are living with HIV, hepatitis B and hepatitis C.

 

New Videos for Clinicians – Syphilis: Symptoms, Serology, and Treatment

SHINE SA, 14/02/2020

SHINE SA have released two new short videos that provide advice for clinicians on syphilis symptoms and treatment. This resource expands on our syphilis overview for clinicians. 

The videos are presented by Sexual Health Physician Dr Carole Khaw, and cover the topics of signs, symptoms and stages as well as serology and treatment.

With an increase in syphilis cases in South Australia it is important that health professionals understand how to identify and treat syphilis.

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