Spatial mapping of gonorrhoea notifications by sexual practice in Victoria, Australia, 2017–2019

Chow, Eric P F; Fairley, Christopher K; Williamson, Deborah A; Chen, Marcus Y

doi:10.1111/1753-6405.13180

Cited by 9 publications

(4 citation statements)

References 7 publications

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“…Our study builds on and extends these past findings by reporting a progressive increase in the likelihood of delayed healthcare seeking among men and women as the distance from a metropolitan sexual health service increases. Our finding is of particular concern because outer Melbourne suburbs have high notification rates of gonorrhea and syphilis, particularly among women ( 29 , 30 ). In addition, our finding that SES by postcode was not associated with a change in the likelihood of delay suggests that geographical distance itself may play a role, rather than being solely reflective of social disadvantage.…”

Section: Discussionmentioning

confidence: 73%

Time to healthcare seeking following the onset of symptoms among men and women attending a sexual health clinic in Melbourne, Australia

Farquharson¹,

Fairley²,

Abraham³

et al. 2022

Front. Med.

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BackgroundTimely diagnosis and treatment of sexually transmitted infections (STIs) underpin their control by reducing the duration of infectiousness. There are currently limited data exploring healthcare seeking among individuals with STI symptoms.MethodsWe analyzed data on individuals reporting STI symptoms at the Melbourne Sexual Health Centre (MSHC) between August 2017 and December 2020. We calculated the time between symptom onset and clinic attendance by risk group for 13 STI diagnoses. We performed univariable and multivariable logistic regression analyses to explore factors associated with delayed healthcare seeking (greater than 7 days).ResultsAmong 7,032 symptomatic clinic attendances, the shortest time to healthcare seeking was among individuals diagnosed with gonococcal urethritis (median 3 days), and the longest was among individuals diagnosed with genital warts (median 60 days). Individuals diagnosed with gonococcal urethritis sought care earlier than individuals diagnosed with non-gonococcal urethritis (median 3 vs. 6 days, p < 0.001), and individuals diagnosed with genital herpes sought care earlier than individuals diagnosed with primary syphilis (median 4 vs. 14 days, p < 0.001). Men who have sex with men, and men taking human immunodeficiency virus pre-exposure prophylaxis (PrEP), were least likely to delay healthcare seeking. Both men and women who delayed healthcare seeking were more likely to live further from the clinic than those who did not delay their presentation [ptrend < 0.001 (men) and ptrend = 0.049 (women)].ConclusionImproved local access to healthcare alongside targeted strategies to encourage early healthcare seeking among groups at increased likelihood of delay may reduce STI-associated morbidity and transmission.

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Section: Discussionmentioning

confidence: 73%

Time to healthcare seeking following the onset of symptoms among men and women attending a sexual health clinic in Melbourne, Australia

Farquharson¹,

Fairley²,

Abraham³

et al. 2022

Front. Med.

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“…In the regions of study, the highest gonorrhea incidence is in the USA, with 206.5 reported cases per 100,000 inhabitants in 2020 (23). In Victoria, the yearly incidence over the three-year period 2017-2019 was 124 per 100,000 (43). In Norway, the reported incidence was much lower, at 31.3 per 100,000 in 2018, slightly higher than the European Economic Area average at 26.4 (36).…”

Section: Import Export and Local Transmission Dynamicsmentioning

confidence: 91%

The inter-continental population dynamics ofNeisseria gonorrhoeae

Osnes

Brynildsrud

Alfsnes

et al. 2023

Preprint

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Neisseria gonorrhoeaeis a globally distributed sexually transmitted bacterial pathogen. Recent studies have revealed that its evolution has been shaped by antibiotic use, while molecular surveillance efforts have demonstrated large changes in lineage composition over relatively short time-spans. However, the global population dynamics ofN. gonorrhoeaeremain unsatisfyingly characterized.To reconstruct recent large-scale population dynamics, we generated a dated phylogeny from 9,732N. gonorrhoeaegenomes and found the effective population size of the species to have expanded gradually over the past two centuries. While the effective population size of clades with reduced susceptibility to extended-spectrum cephalosporins started declining around 2010, a major clade containing a mosaicmtroperon associated with cephalosporin susceptibility and decreased azithromycin did not display any reduction in population size.Using ancestral trait reconstruction analyses, we delineated transmission lineages, defined as groups of sequences in which all the samples can be traced back to the same import event to a given location. Import, export and local transmission dynamics across two densely sampled locations (Norway and Victoria, Australia) were investigated in detail. Norway exhibited substantially higher rates of strain import and export compared to Victoria, where incidence was to a larger extent fuelled by locally transmitted lineages. Taken together, our work highlights the power of large-scale phylogenomic analyses to uncover the complex dynamics of lineage transmission inN. gonorrhoeae.

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“…Primary outcomes were CLD in survivors and death. CLD is defined as continued need for any form of respiratory support (supplemental oxygen and/or assisted ventilation) beyond 36 weeks postmenstrual age [21, 22]. Secondary outcomes included retinopathy of prematurity requiring intervention, NEC defined radiologically or histologically, duration of mechanical ventilation, LOS, hearing impairment defined as use of either bilateral hearing aids or unilateral/bilateral cochlear implants, bilateral blindness, and neurodevelopmental outcome using Bayley Scales of Infant and Toddler Development-3 (BSID-3) between 18 and 42 months of age, and effect of treatment on morbidity and mortality.…”

Section: Methodsmentioning

confidence: 99%

Symptomatic Postnatal Cytomegalovirus Infection in Less than 32-Week Preterm Infants: 13-Year Retrospective Multicenter Case-Control Study

et al. 2023

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Introduction: Reports on the influence of postnatal cytomegalovirus (pCMV) infection in neonatal outcomes of preterm babies vary while guidance on management including screening is lacking. We aim to determine the association between symptomatic pCMV infection and chronic lung disease (CLD) and mortality in preterm infants born less than 32 weeks gestation. Methods: We used data from the Neonatal Intensive Care Units’ (NICUS) population-based prospective data registry of infants in 10 neonatal units in New South Wales and the Australian Capital Territory, Australia. De-identified perinatal and neonatal outcome data for 40,933 infants were examined. We identified 172 infants <32 weeks gestation with symptomatic pCMV infection. Each was matched with one control infant. Results: Infants with symptomatic pCMV infection were 2.7 times more likely to develop CLD (OR 2.7, 95% CI: 1.7–4.5) and spend 25.2 days more in hospital (95% CI: 15.2–35.2). Seventy-five percent (129/172) of infants with symptomatic pCMV were extremely preterm (<28 weeks). The mean age of symptomatic pCMV diagnosis was 62.5 ± 20.5 days or 34.7 ± 3.6 weeks-corrected gestational age. Ganciclovir treatment did not decrease CLD and death. CLD was 5.5 times predictive of death in patients with symptomatic pCMV infection. Symptomatic pCMV infection did not influence mortality nor increase neurologic impairment. Conclusion: Symptomatic pCMV is a modifiable factor affecting extreme preterm infants with significant impact on CLD. Prospective study on screening and treatment will help unveil potential benefits in our already at-risk preterm infants.

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Spatial mapping of gonorrhoea notifications by sexual practice in Victoria, Australia, 2017–2019

Cited by 9 publications

References 7 publications

Time to healthcare seeking following the onset of symptoms among men and women attending a sexual health clinic in Melbourne, Australia

Time to healthcare seeking following the onset of symptoms among men and women attending a sexual health clinic in Melbourne, Australia

The inter-continental population dynamics ofNeisseria gonorrhoeae

Symptomatic Postnatal Cytomegalovirus Infection in Less than 32-Week Preterm Infants: 13-Year Retrospective Multicenter Case-Control Study

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