Estimating the prevalence of Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, and human papillomavirus infection in indigenous women in northern Australia

Abstract

Objective: To estimate more accurately the age specific prevalence of Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, and human papillomavirus infection (HPV) in indigenous women living in urban, rural, and remote areas of the "Top End" of the Northern Territory (NT). Design: Analysis of data obtained from two community based studies using self administered tampon specimens tested by polymerase chain reaction for sexually transmitted disease (STD). Data pertaining to the notifiable STDs (N gonorrhoeae and C trachomatis) were obtained from the NT health department. Patients: 1090 indigenous women (age range 12-73 years) were enrolled when they attended local community health centres, family planning clinics, and STD clinics. The majority attended clinics in their home community in the course of "well women's checks" which encourage women to undergo screening for a variety of general medical conditions. Results: The overall prevalence of T vaginalis, C trachomatis, N gonorrhoeae, and HPV was 0.25 (95% CI: 0.22-0.28), 0.11 (0.09-0.13), 0.17 (0.15-0.19), and 0.42 (0.37-0.48) respectively. Of the women found to be infected (excluding HPV), 25.5% had two or more of the above organisms detected. There was a statistically significant increase in the age specific prevalence of T vaginalis but a significant decrease with age for C trachomatis and HPV infection. There was no statistically significant change for N gonorrhoeae with age. Conclusions: STDs are hyperendemic in this population of indigenous women and the notification data significantly underestimate their prevalence. Distinct patterns of age specific prevalence were demonstrated, highlighting the need to tailor control strategies to specific epidemiological features. (Sex Transm Inf 1999;75:431-434)

Sex in Australia: The rationale and methods of the Australian Study of Health and Relationships

“…Our methods will have under-represented Indigenous Australians in remote communities, among whom high STI prevalence has been found. [44][45][46][47][48] Methods other than telephone surveys may be better suited to collecting information from remote Indigenous populations. A strength of the random digit dialling method over selecting from directories was that households with silent or unlisted numbers were within the scope of the survey.…”

Drug resistance in the sexually transmitted protozoan Trichomonas vaginalis

“…Chronic infections have been associated with pre-term birth and low birth-weight neonates, cervical cancer and increased HIV transmission amongst the most alarming [16][17][18]. Infection rates have been reported as high as 67% in Mongolia in 1998 [19], 40-60 % in Africa, 40% in Indigenous Australians over 40 years of age [20], and 46% in highland women of Papua New Guinea [21,22]. Trichomoniasis has the highest prevalence and incidence of any STI, and its eradication may well be the single most cost-effective step in HIV incidence reduction [23,24].…”

Adolescence and sexually transmitted infections: the case in the coastal regions in Madagascar

“…In the north of Australia, the authors have found that a study carried out on aboriginal women has found an increase in the prevalence of the infection in T. vaginalis with age. 12,13 According to other authors, unlike Chlamydia trachomatis and N. gonorrhoeae, the young age is not a risk factor of trichomoniasis. The prevalence of T. vaginalis appears to increase with age for both sexes, perhaps due to the nature frequent asymptomatic infection and consequently the persistence of untreated infections.…”

“…The prevalence of T. vaginalis appears to increase with age for both sexes, perhaps due to the nature frequent asymptomatic infection and consequently the persistence of untreated infections. 12 The unprotected sex with multiple partners increases the chances of an infection by T. vaginalis, as other STI. There is no doubt that the protection of sex with a condom helps to prevent the vaginal infection of T. vaginalis as well as other STI.…”