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Estimating gonorrhoea prevalence in young heterosexual men and women attending community-based sexual health services to inform decisions on gonorrhoea testing

  • K. TOWN (a1), M. FUREGATO (a1), N. FIELD (a1) (a2) and G. HUGHES (a1)

Summary

In England, dual tests detecting chlamydia and gonorrhoea are used in specialist and community-based sexual health services (SHSs). Test performance is poor when prevalence is low, therefore UK national guidelines recommend against opportunistic gonorrhoea screening unless there is a clear local public health need. While surveillance data on gonorrhoea prevalence is comprehensive in specialist SHSs, it is sparse in community SHSs. We aimed to estimate gonorrhoea prevalence in heterosexual men and women aged 15–24 attending community SHSs to inform testing care pathways. We used linear and quadratic regression to model the relationship between prevalence in community and specialist SHSs in local authorities (LAs) with available surveillance data. We applied best-fitting models to predict prevalence in community SHSs in remaining LAs. Data from community SHSs were available for 102/326 LAs. There was a weak positive association between gonorrhoea prevalence in community and specialist SHSs in corresponding LAs within (R 2 = 0·13, P = 0·058) and outside (R 2 = 0·07, P = 0·02) London. Applying best-fitting models, we estimated a median gonorrhoea prevalence of 0·5% (mean 0·6%; range 0·2%–2·7%) in heterosexuals attending community SHSs. Despite some unexplained variation, our analyses suggest gonorrhoea prevalence in young heterosexuals attending community SHSs is below 1% in most English LAs. Our findings re-inforce the current national guidelines that recommend care pathways for gonorrhoea testing in community SHSs include confirmatory testing to reduce the risk of misdiagnosis and inappropriate management.

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Copyright

Corresponding author

*Author for correspondence: K. Town, HIV/STI Department, National Infections Service, Public Health England, PHE Colindale, 61 Colindale Avenue, London NW9 5EQ, UK. (Email: katy.town@phe.gov.uk)

References

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1. Public Health England. Health Protection Report. Sexually transmitted infections and chlamydia screening in England, 2015. 2016; 10: 22.
2. Sonnenberg, P, et al. Prevalence, risk factors, and uptake of interventions for sexually transmitted infections in Britain: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal). Lancet 2013; 382: 17951806.
3. Field, N, et al. Confirmatory assays are essential when using molecular testing for Neisseria gonorrhoeae in low-prevalence settings: insights from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Sexually Transmitted Infections 2015; 91: 338341.
4. Field, N, et al. Screening for gonorrhoea using samples collected through the English National Chlamydia Screening Programme and risk of false positives: a national survey of Local Authorities. BMJ Open 2014; 4: e006067.
5. Public Health England. National chlamydia screening programme standards (7th edition) (https://www.gov.uk/government/publications/ncsp-standards). Accessed 1 February 2017.
6. Public Health England. Guidance for the detection of gonorrhoea in England (https://www.gov.uk/government/publications/guidance-for-the-detection-of-gonorrhoea-in-england). Accessed 1 February 2017.
7. Savage, EJ, et al. Improving surveillance of sexually transmitted infections using mandatory electronic clinical reporting: the genitourinary medicine clinic activity dataset, England, 2009 to 2013. Euro Surveillance: Bulletin Europeen sur les Maladies Transmissibles = European Communicable Disease Bulletin 2014; 19: 20981.
8. M B. An Introduction to Medical Statistics, 3rd edn. Oxford Medical Publications, Oxford University Press, 2000.
9. Mebrahtu, HFM, et al. Access of non-specialist sexual health services by men who have sex with men: do they differ from those attending specialist services? Sexually Transmitted Infections. Online First: 25 November 2016.
10. Cook, PA, et al. Comparison of patients diagnosed with gonorrhoea through community screening with those self-presenting to the genitourinary medicine clinic. BMJ Open 2014; 4: e004862.
11. Chow, EP, et al. Gonorrhoea notifications and nucleic acid amplification testing in a very low-prevalence Australian female population. Medical Journal of Australia 2015; 202: 321323.

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