Coinfection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis: A crosssectional analysis of positivity and risk factors in remote Australian Aboriginal communities

Rebecca Guy, James Ward, Handan Wand, Alice Rumbold, Linda Garton, Belinda Hengel, Bronwyn Silver, Debbie Taylor-Thomson, Janet Knox, Skye McGregor, Amalie Dyda, Christopher Fairley, Lisa Maher, Basil Donovan, John Kaldor, STRIVE Investigator Group

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23 Citations (Scopus)

Abstract

Objectives To determine the co-occurrence and epidemiological relationships of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) in a high-prevalence setting in Australia. Methods In the context of a cluster randomised trial in 68 remote Aboriginal communities, we obtained laboratory reports on simultaneous testing for CT, NG and TV by nucleic acid amplification tests in individuals aged ≤16 years and examined relationships between age and sex and the coinfection positivity. ORs were used to determine which infections were more likely to co-occur by demographic category. Results Of 13 480 patients (median age: 30 years; men: 37%) tested for all three infections during the study period, 33.3% of women and 21.3% of men had at least one of them, highest in patients aged 16-19 years (48.9% in women, 33.4% in men). The most frequent combination was CT/NG (2.0% of women, 4.1% of men), and 1.8% of women and 0.5% of men had all three. In all co-combinations, coinfection positivity was highest in patients aged 16-19 years. CT and NG were highly predictive of each other's presence, and TV was associated with each of the other two infections, but much more so with NG than CT, and its associations were much stronger in women than in men. Conclusions In this remote high-prevalence area, nearly half the patients aged 16-19 years had one or more sexually transmitted infections. CT and NG were more common dual infections. TV was more strongly associated with NG coinfections than with CT. These findings confirm the need for increased simultaneous screening for CT, NG and TV, and enhanced control strategies.

LanguageEnglish
Pages201-206
Number of pages6
JournalSexually Transmitted Infections
Volume91
Issue number3
DOIs
Publication statusPublished - 1 May 2015

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

Cite this

Guy, Rebecca ; Ward, James ; Wand, Handan ; Rumbold, Alice ; Garton, Linda ; Hengel, Belinda ; Silver, Bronwyn ; Taylor-Thomson, Debbie ; Knox, Janet ; McGregor, Skye ; Dyda, Amalie ; Fairley, Christopher ; Maher, Lisa ; Donovan, Basil ; Kaldor, John ; STRIVE Investigator Group. / Coinfection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis : A crosssectional analysis of positivity and risk factors in remote Australian Aboriginal communities. In: Sexually Transmitted Infections. 2015 ; Vol. 91, No. 3. pp. 201-206.
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title = "Coinfection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis: A crosssectional analysis of positivity and risk factors in remote Australian Aboriginal communities",
abstract = "Objectives To determine the co-occurrence and epidemiological relationships of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) in a high-prevalence setting in Australia. Methods In the context of a cluster randomised trial in 68 remote Aboriginal communities, we obtained laboratory reports on simultaneous testing for CT, NG and TV by nucleic acid amplification tests in individuals aged ≤16 years and examined relationships between age and sex and the coinfection positivity. ORs were used to determine which infections were more likely to co-occur by demographic category. Results Of 13 480 patients (median age: 30 years; men: 37{\%}) tested for all three infections during the study period, 33.3{\%} of women and 21.3{\%} of men had at least one of them, highest in patients aged 16-19 years (48.9{\%} in women, 33.4{\%} in men). The most frequent combination was CT/NG (2.0{\%} of women, 4.1{\%} of men), and 1.8{\%} of women and 0.5{\%} of men had all three. In all co-combinations, coinfection positivity was highest in patients aged 16-19 years. CT and NG were highly predictive of each other's presence, and TV was associated with each of the other two infections, but much more so with NG than CT, and its associations were much stronger in women than in men. Conclusions In this remote high-prevalence area, nearly half the patients aged 16-19 years had one or more sexually transmitted infections. CT and NG were more common dual infections. TV was more strongly associated with NG coinfections than with CT. These findings confirm the need for increased simultaneous screening for CT, NG and TV, and enhanced control strategies.",
author = "Rebecca Guy and James Ward and Handan Wand and Alice Rumbold and Linda Garton and Belinda Hengel and Bronwyn Silver and Debbie Taylor-Thomson and Janet Knox and Skye McGregor and Amalie Dyda and Christopher Fairley and Lisa Maher and Basil Donovan and John Kaldor and {STRIVE Investigator Group}",
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Guy, R, Ward, J, Wand, H, Rumbold, A, Garton, L, Hengel, B, Silver, B, Taylor-Thomson, D, Knox, J, McGregor, S, Dyda, A, Fairley, C, Maher, L, Donovan, B, Kaldor, J & STRIVE Investigator Group 2015, 'Coinfection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis: A crosssectional analysis of positivity and risk factors in remote Australian Aboriginal communities', Sexually Transmitted Infections, vol. 91, no. 3, pp. 201-206. https://doi.org/10.1136/sextrans-2014-051535

Coinfection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis : A crosssectional analysis of positivity and risk factors in remote Australian Aboriginal communities. / Guy, Rebecca; Ward, James; Wand, Handan; Rumbold, Alice; Garton, Linda; Hengel, Belinda; Silver, Bronwyn; Taylor-Thomson, Debbie; Knox, Janet; McGregor, Skye; Dyda, Amalie; Fairley, Christopher; Maher, Lisa; Donovan, Basil; Kaldor, John; STRIVE Investigator Group.

In: Sexually Transmitted Infections, Vol. 91, No. 3, 01.05.2015, p. 201-206.

Research output: Contribution to journalArticle

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T1 - Coinfection with Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis

T2 - Sexually Transmitted Infections

AU - Guy, Rebecca

AU - Ward, James

AU - Wand, Handan

AU - Rumbold, Alice

AU - Garton, Linda

AU - Hengel, Belinda

AU - Silver, Bronwyn

AU - Taylor-Thomson, Debbie

AU - Knox, Janet

AU - McGregor, Skye

AU - Dyda, Amalie

AU - Fairley, Christopher

AU - Maher, Lisa

AU - Donovan, Basil

AU - Kaldor, John

AU - STRIVE Investigator Group

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Objectives To determine the co-occurrence and epidemiological relationships of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) in a high-prevalence setting in Australia. Methods In the context of a cluster randomised trial in 68 remote Aboriginal communities, we obtained laboratory reports on simultaneous testing for CT, NG and TV by nucleic acid amplification tests in individuals aged ≤16 years and examined relationships between age and sex and the coinfection positivity. ORs were used to determine which infections were more likely to co-occur by demographic category. Results Of 13 480 patients (median age: 30 years; men: 37%) tested for all three infections during the study period, 33.3% of women and 21.3% of men had at least one of them, highest in patients aged 16-19 years (48.9% in women, 33.4% in men). The most frequent combination was CT/NG (2.0% of women, 4.1% of men), and 1.8% of women and 0.5% of men had all three. In all co-combinations, coinfection positivity was highest in patients aged 16-19 years. CT and NG were highly predictive of each other's presence, and TV was associated with each of the other two infections, but much more so with NG than CT, and its associations were much stronger in women than in men. Conclusions In this remote high-prevalence area, nearly half the patients aged 16-19 years had one or more sexually transmitted infections. CT and NG were more common dual infections. TV was more strongly associated with NG coinfections than with CT. These findings confirm the need for increased simultaneous screening for CT, NG and TV, and enhanced control strategies.

AB - Objectives To determine the co-occurrence and epidemiological relationships of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) in a high-prevalence setting in Australia. Methods In the context of a cluster randomised trial in 68 remote Aboriginal communities, we obtained laboratory reports on simultaneous testing for CT, NG and TV by nucleic acid amplification tests in individuals aged ≤16 years and examined relationships between age and sex and the coinfection positivity. ORs were used to determine which infections were more likely to co-occur by demographic category. Results Of 13 480 patients (median age: 30 years; men: 37%) tested for all three infections during the study period, 33.3% of women and 21.3% of men had at least one of them, highest in patients aged 16-19 years (48.9% in women, 33.4% in men). The most frequent combination was CT/NG (2.0% of women, 4.1% of men), and 1.8% of women and 0.5% of men had all three. In all co-combinations, coinfection positivity was highest in patients aged 16-19 years. CT and NG were highly predictive of each other's presence, and TV was associated with each of the other two infections, but much more so with NG than CT, and its associations were much stronger in women than in men. Conclusions In this remote high-prevalence area, nearly half the patients aged 16-19 years had one or more sexually transmitted infections. CT and NG were more common dual infections. TV was more strongly associated with NG coinfections than with CT. These findings confirm the need for increased simultaneous screening for CT, NG and TV, and enhanced control strategies.

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U2 - 10.1136/sextrans-2014-051535

DO - 10.1136/sextrans-2014-051535

M3 - Article

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SP - 201

EP - 206

JO - Sexually Transmitted Infections

JF - Sexually Transmitted Infections

SN - 1368-4973

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