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Lyu H, Tang H, Feng Y, Hu S, Wang Y, Zhou L, Huang S, Li J, Zhu H, He X, Tang W, Zhou Y, Zhang L. Incidence and spontaneous clearance of gonorrhea and chlamydia infections among men who have sex with men: a prospective cohort study in Zhuhai, China. Front Public Health 2024; 12:1348686. [PMID: 38770362 PMCID: PMC11102956 DOI: 10.3389/fpubh.2024.1348686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 04/22/2024] [Indexed: 05/22/2024] Open
Abstract
Background Men who have sex with men (MSM) face significant risks of Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG) infection. Nevertheless, only limited studies have looked into the site-specific infection and clearance of CT/NG. In order to prevent transmission, it is essential to understand the underlying factors that drive infection and spontaneous clearance. Methods A 12-week cohort study examined the association between CT/NG infection, self-clearance, and sexual behaviors among MSM. The Willingness Service recruited participants who completed weekly questionnaires and provided urine, throat, and rectal swab samples. Results The study involved 151 men, in which 51 (33.8%) were diagnosed with CT/NG infection during the study period. HIV (OR = 11.31), kissing (OR = 1.59), receptive oral sex (OR = 36.64), and insertive anal sex (OR = 19.73) constituted significant risk factors. 100% condom use (OR = 5.78) and antibiotic (OR = 7.53) were more likely to cause spontaneous clearance. Discussion MSM may engage in riskier sexual behaviors due to insufficient knowledge and awareness of STI prevention, leading to increased susceptibility to NG/CT. It is crucial to concentrate on enhancing health education for MSM. Conclusion This study found that the rectum was the most prevalent site of CT/NG and sexual behavior can influence the infection. Additionally, the appropriate use of antibiotics and consistent condom use may contribute to clear spontaneously.
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Affiliation(s)
- Hang Lyu
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Haotong Tang
- Jieyang Center for Disease Control and Prevention, Jieyang, China
| | - Yunlong Feng
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Shuyan Hu
- Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
| | - Yuyu Wang
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Lanlan Zhou
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Shanzi Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Jiarun Li
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Huamei Zhu
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Xi He
- Zhuhai Xutong Voluntary Services Center, Zhuhai, China
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Yi Zhou
- Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Lei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
- Artificial Intelligence and Modelling in Epidemiology Program, Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Oliveira CM, Marques LM, de Medeiros DS, Salgado VDJ, Soares F, Magno L, Dourado I, da Silva ÁMB, de Brito HIL, Figueiredo TB, Campos GB. Prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis infections among adolescent men who have sex with men and transgender women in Salvador, Northeast Brazil. Epidemiol Infect 2023; 151:e196. [PMID: 37869965 PMCID: PMC10728983 DOI: 10.1017/s095026882300170x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/29/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023] Open
Abstract
Adolescent men who have sex with men (AMSM) and transgender women (ATGW) enrolled as part of the PrEP1519 study between April 2019 and February 2021 in Salvador were tested for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections.We performed real-time polymerase chain reaction using oropharyngeal, anal, and urethral swabs; assessed factors associated with NG and CT infections using multivariable Poisson regression analysis with robust variance; and estimated the prevalence ratios (PRs) and 95% confidence intervals (95% CIs). In total, 246 participants were included in the analyses (median age: 18.8; IQR: 18.2-19.4 years). The overall oropharyngeal, anal, and urethral prevalence rates of NG were 17.9%, 9.4%, 7.6%, and 1.9%, respectively. For CT, the overall, oropharyngeal, anal, and urethral prevalence rates were 5.9%, 1.2%, 2.4%, and 1.9%, respectively. A low level of education, clinical suspicion of STI (and coinfection with Mycoplasma hominis were associated with NG infection. The prevalence of NG and CT, especially extragenital infections, was high in AMSM and ATGW. These findings highlight the need for testing samples from multiple anatomical sites among adolescents at a higher risk of STI acquisition, implementation of school-based strategies, provision of sexual health education, and reduction in barriers to care.
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Affiliation(s)
| | - Lucas Miranda Marques
- Multidisciplinary Institute for Health, Federal University of Bahia, Salvador, Brazil
- State University of de Santa Cruz, Ilhéus, Brazil
| | | | | | - Fabiane Soares
- Collective Health Institute, Federal University of Bahia, Salvador, Brazil
| | - Laio Magno
- Collective Health Institute, Federal University of Bahia, Salvador, Brazil
- Department of Life Sciences, State University of Bahia, Salvador, Brazil
| | - Inês Dourado
- Collective Health Institute, Federal University of Bahia, Salvador, Brazil
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Bardach A, Alconada T, Palermo C, Rojas-Roque C, Sandoval MM, Gomez J, Pinto T, Ciapponi A. Burden of Disease of Gonorrhoea in Latin America: Systematic Review and Meta-analysis. Infect Dis Ther 2023:10.1007/s40121-023-00814-0. [PMID: 37261611 DOI: 10.1007/s40121-023-00814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/19/2023] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION Neisseria gonorrhoeae causes gonorrhoea, a globally neglected but increasing disease. This systematic review and meta-analysis reviewed the epidemiology and economic burden of gonorrhoea in Latin America and the Caribbean (LAC). METHODS We searched PubMed, EMBase, Cochrane Library, EconLIT, CINAHL, CRD, LILACS, Global Health, Global Dissertations and Theses, SciELO, Web of Science databases, countries' ministries of health, and the IHME's Global Burden of Disease databases. Studies published in the last 10 years (20 years for economic studies) were included if conducted in any LAC country, without language restrictions. The main outcome measures were incidence/prevalence, proportion of co-infections, case fatality rates, specific mortality/hospitalisation rates, direct/indirect costs, and impact of gonorrhoea on quality of life. To assess evidence quality, we used a checklist developed by the US National Heart, Lung, and Blood Institute for observational studies and trial control arms, the Cochrane Effective Practice Organization of Care Group tool for randomised controlled trials, and the CICERO checklist for economic studies. RESULTS We identified 1290 articles; 115 included epidemiological studies and one included an economic study. Ministry of health data from Argentina, Brazil, Chile, Colombia, Mexico, and Uruguay were identified. Gonorrhoea prevalence was 1.46% (95% confidence interval [CI] 1.00-2.00%) from 48 studies and 5.68% (95% CI 4.23-7.32%) from 58 studies for non-high-risk and high-risk populations, respectively. Cumulative incidence for the high-risk population was 2.05 cases per 100 persons/year. Few published studies were rated as "good" in the risk of bias assessments. Variations in the methodology of the sources and limited information found in the countries' surveillance systems hinder the comparison of data. CONCLUSION The burden of gonorrhoea in LAC is not negligible. Our results provide public health and clinical decision support to assess potential interventions to prevent gonorrhoea. TRIAL REGISTRATION The protocol is registered on PROSPERO (CRD42021253342). The study was funded by GlaxoSmithKline Biologicals SA (GSK study identifier VEO-000025).
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Affiliation(s)
- Ariel Bardach
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Tomás Alconada
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Carolina Palermo
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - Carlos Rojas-Roque
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | - María Macarena Sandoval
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina
| | | | | | - Agustin Ciapponi
- Institute for Clinical Effectiveness and Health Policy, Dr Emilio Ravignani 2024, C1014CPV, Buenos Aires, Argentina.
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Tu W, Li YY, Kuang YQ, Xie RH, Dong XQ, Zhang D, Ma YL, Zhang WY, Lu L. High prevalence of sexually transmitted infections and risk factors among HIV-positive individuals in Yunnan, China. Eur J Med Res 2022; 27:9. [PMID: 35027093 PMCID: PMC8756631 DOI: 10.1186/s40001-022-00635-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/04/2022] [Indexed: 11/12/2022] Open
Abstract
Background Yunnan has the highest rates of HIV in China. Other treatable sexually transmitted infections (STIs) are associated with accelerated HIV transmission and poor ART outcomes, but are only diagnosed by syndromic algorithms. Methods We recruited 406 HIV-positive participants for a cross-sectional study (204 ART-naive and 202 receiving ART). Blood samples and first-voided urine samples were collected. Real-time polymerase chain reaction methods were used for diagnosing Chlamydia trachomatis (CT), Neisseria gonorrhea (NG) and Mycoplasma genitalium (MG). Syphilis and herpes simplex virus type 2 (HSV-2) tests were also performed. Results Among the 406 participants, the overall prevalence of STIs was 47.0% and 45.1% in ART-naive individuals and 49.0% in individuals receiving ART, respectively. The testing frequencies were 11.6% (11.8% vs. 11.4%), 33.2% (29.4% vs. 37.1%), 3.2% (3.4% vs. 3.0%), 2.0% (3.4% vs. 0.5%) and 4.7% (6.4% vs. 3.0%) for active syphilis, HSV-2, CT, NG and MG, respectively. The percentage of multiple infections in both groups was 10.8% (22/204) in ART-naive participants and 9.9% (20/202) in participants receiving ART. Female sex, an age between 18 and 35 years, ever injecting drugs, homosexual or bisexual status, HIV/HBV coinfection, and not receiving ART were identified as risk factors. Self-reported asymptomatic patients were not eliminated from having a laboratory-diagnosed STI. Conclusions The STI prevalence was 47.0% (45.1% vs. 49.0%), and HSV-2, syphilis and MG were the most common STIs in HIV-infected individuals. We found a high prevalence (6.4%) of MG in ART-naive individuals. HIV-positive individuals tend to neglect or hide their genital tract discomfort; thus, we suggest strengthening STI joint screening and treatment services among HIV-infected individuals regardless of whether they describe genital tract discomfort.
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Affiliation(s)
- Wei Tu
- Department of Public Health, Kunming Medical University, Kunming, 650500, China
| | - Yu-Ye Li
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China.
| | - Yi-Qun Kuang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, 650032, China.
| | - Rong-Hui Xie
- Yunnan Provincial Hospital of Infectious Diseases/Yunnan AIDS Care Center (YNACC), Anning, 650300, China
| | - Xing-Qi Dong
- Yunnan Provincial Hospital of Infectious Diseases/Yunnan AIDS Care Center (YNACC), Anning, 650300, China
| | - Dan Zhang
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Yan-Ling Ma
- Yunnan Centers for Disease Control and Prevention, Kunming, 650022, China
| | - Wan-Yue Zhang
- Yunnan Centers for Disease Control and Prevention, Kunming, 650022, China
| | - Lin Lu
- Department of Public Health, Kunming Medical University, Kunming, 650500, China.
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