Nsuami M J, Taylor S N, Smith B S, Martin D H
School of Medicine, Department of Medicine, Section of Infectious Diseases, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
Sex Transm Infect. 2009 Jun;85(3):194-8. doi: 10.1136/sti.2008.031781. Epub 2008 Oct 27.
To determine the prevalence of Neisseria gonorrhoeae in a student population before hurricane Katrina and after their residential neighbourhoods were devastated in the wake of the hurricane.
Students in a New Orleans public high school were offered urine screening for N gonorrhoeae and Chlamydia trachomatis using nucleic acid amplification tests before (n = 346) and after (n = 333) hurricane Katrina. Based on studies showing gonorrhea clustering in physically deteriorated neighbourhoods, it was hypothesised that the post-Katrina gonorrhea prevalence would be higher among students whose neighbourhoods still showed signs of deterioration in the aftermath of the hurricane.
Before and after hurricane Katrina, the prevalence of gonorrhea increased from 2.3% (8/346, 95% CI 1.3% to 4.6%) to 5.1% (17/333, 95% CI 3.1% to 8.2%), respectively (one-sided p = 0.027). In logistic regression of gonorrhea controlling for gender, age, chlamydia infection and exposure to hurricane-affected residential neighbourhood conditions, gonorrhea was significantly associated with female gender (odds ratio (OR) 2.6, 95% CI 1.0 to 6.3; p = 0.04) and with chlamydia infection (OR 9.2, 95% CI 3.9 to 21.7; p<0.001). Although of weak statistical significance, there was a strong independent positive trend toward testing positive for gonorrhea after the hurricane (OR 2.2, 95% CI 0.9 to 5.4; p = 0.09).
The analysis indicates that the odds of testing positive for gonorrhea more than doubled among students after the hurricane, indicating that surveillance activities should be restored to monitor sexually transmitted infections (STIs) among at-risk populations. Redoubled efforts should be put into STI screening programmes as soon as possible following natural disasters to prevent resurgent STI incidence rates.
确定卡特里娜飓风来袭前以及学生居住社区在飓风后遭受破坏后，学生群体中淋病奈瑟菌的感染率。
在卡特里娜飓风来袭前（n = 346）和飓风过后（n = 333），对新奥尔良一所公立高中的学生进行淋病奈瑟菌和沙眼衣原体的尿液筛查，采用核酸扩增检测法。基于研究表明淋病在物质条件恶化的社区聚集，研究假设在飓风过后社区仍有恶化迹象的学生中，淋病感染率会更高。
卡特里娜飓风前后，淋病感染率分别从2.3%（8/346，95%可信区间1.3%至4.6%）升至5.1%（17/333，95%可信区间3.1%至8.2%）（单侧p = 0.027）。在对淋病进行逻辑回归分析时，控制了性别、年龄、衣原体感染以及受飓风影响的居住社区条件，结果显示淋病与女性性别显著相关（比值比（OR）2.6，95%可信区间1.0至6.3；p = 0.04），与衣原体感染也显著相关（OR 9.2，95%可信区间3.9至21.7；p<0.001）。尽管统计学意义较弱，但飓风过后淋病检测呈阳性存在强烈的独立正向趋势（OR 2.2，95%可信区间0.9至5.4；p = 0.09）。
分析表明，飓风过后学生中淋病检测呈阳性的几率增加了一倍多，这表明应恢复监测活动，以监测高危人群中的性传播感染（STIs）。自然灾害后应尽快加倍努力开展性传播感染筛查项目，以防止性传播感染发病率再次上升。
