Spatiotemporal analysis of 11 years of Chlamydia trachomatis data from southern China

Abstract

Background: Urogenital Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) globally. Reviews suggest high and persistently endemic STI epidemics in low and middle income countries. However population-based prevalence estimates in these settings are less common, underscoring the need for analyses of available data to characterize patterns of disease burden. We identified spatio-temporal clusters and key behavioral, social, or environmental factors contribution to transmission in order to inform the prioritization and targeting of evidence based interventions. Methods: Using 11 years of data (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) from the chlamydia case report system of Guangdong, China, we identified county level spatio-temporal hot and cold spots using the Getis-Ord Gi * statistic and discrete Poisson models in SaTScan 9.6. We also estimated associations between observed distribution patterns and area-level demographic, social, and economic factors using quasi-Poisson regression models that controlled for annual counts of certified laboratories to account for fluctuations in location-specific detection capacity. Findings: Cluster analysis indicates an expanding chlamydia epidemic in Guangdong, with cases clustered in regions of greatest economic activity. Greater male-to-female sex ratio (RR, 3.63; 95% CI, 1.41-9.45) and greater urbanicity (RR, 2.44; 95% CI, 1.98-2.99) were predictive of higher chlamydia case occurrence. Interpretation: We found that chlamydia case occurrence in Guangdong province has been accelerating over the past 11 years and that its expansion is tied to indicators of social and economic development. These estimates not only identify high prevalence regions to target but also areas where data gaps potentially remain. The salience of sex ratios and urbanicity may best be understood through the lens of China's modern history of labor migration which has reshaped the gender dynamics and health access landscape of urban China. Future chlamydia control effort s will require a population-based approach focused on reengaging sexually active adults of diverse economic and migratory backgrounds. Funding: This was an unfunded study using routinely collected public health data.

New Syphilis Cases in Older Adults, 2004–2019: An Analysis of Surveillance Data From South China

“…We found that the city-specific burden of new syphilis diagnoses among older adults was heterogeneous, with cities in the northern region and western region generally reporting the highest syphilis notification rates in Guangdong, in contrast with the patterns among younger adults that the highest syphilis notification rates was generally reported by the cities in the Pearl River Delta region. This difference might be understood through the lens of Guangdong's labour migrant experience due to the vast territory and economic disequilibrium ( 12 ). The Pearl River Delta region is known as the national migration destination where the economic development is much higher than other regions in Guangdong.…”

“…A proxy is provided by surveillance of new syphilis cases reported over time. In settings like China with a rapidly ageing population ( 11 ) and sufficiently developed primary healthcare systems and disease reporting infrastructure ( 12 ), in-depth descriptive analyses of newly reported syphilis cases can inform policy decisions and the design of effective interventions for this age group. This can be particularly instructive for other LMIC settings undergoing similarly rapid social and economic change.…”

The prevalence and correlates of unintended pregnancy among female sex workers in South China: a cross-sectional study

“…the past decade [11][12][13]. In addition, the number of induced abortions in Guangdong province reached 1.2 million in 2018, which ranked rst in the number of induced abortion cases in China [14].…”

Prevalence of Chlamydia trachomatis Sequence Types 4 and 80 in Infertile Couples in North Khorasan, Iran

“…It is considered a significant global public health concern by the World Health Organization (WHO) for several reasons. Firstly, it has a high prevalence and incidence rate, with millions of new cases reported annually [5,6] . Secondly, if left untreated, Chlamydia could lead to severe complications in the reproductive system, causing infertility in both men and women.…”

“…Secondly, if left untreated, Chlamydia could lead to severe complications in the reproductive system, causing infertility in both men and women. Thirdly, it increases the risk of transmission and acquisition of HIV [5,6] . Fourthly, the infection often progresses with mild or no symptoms, contributing to its widespread transmission [7,8] .…”