Fagan Patricia S, Downing Sandra G, McCall Bradley, Carroll Heidi J, Howard Therese M, Palmer Cheryn M
School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns campus,Cairns, Queensland.
Senior Lecturer, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns Campus,Cairns, Queensland.
Commun Dis Intell Q Rep. 2013 Sep 30;37(3):E253-9. doi: 10.33321/cdi.2013.37.38.
Gonorrhoea is an important sexually transmitted notifiable condition. This paper describes findings from two gonorrhoea enhanced surveillance programs operating during the 2000s in Queensland: one in the remote Torres and Northern Peninsula Area (T&NPA); the other in an urban region. The overall response rate in the T&NPA (2006-2011) was 82% (723 of 879), and in Brisbane Southside and West Moreton (BSWM) (2003-2011), it was 62% (1,494 of 2,401 notifications). In the T&NPA, cases were young (80% <25 years), Indigenous (97%) and 44% were male. In the BSWM, cases were predominantly male (76%), non-Indigenous (92%) and 42% were aged less than 25 years. Co-infection with chlamydia was found in 54% of males and 60% of females in the Torres, and in 18% of males and 35% of females in the BSWM. In the BSWM 35% of the men without a syphilis test recorded had reported sexual contact with men; similarly 34% of the men without an HIV test recorded had reported sexual contact with men. Compliance with recommended treatment (ceftriaxone) was greater than 90% in all years except 2008 (84%) in the T&NPA. Treatment compliance increased significantly, from 40% in 2003 to 84.4% in 2011 (P<0.0001) in the BSWM cohort. The proportion of contacts with a documented treatment date increased significantly in the T&NPA from 56% in 2009 to 76% in 2011 (P=0.019), after a system for follow-up with the clinician became routine. Gonorrhoea epidemiology and management challenges vary across Queensland populations. Enhanced surveillance allows public health authorities to monitor epidemiology and reminds clinicians to prioritise effective sexually transmitted infection treatment for their clients.
淋病是一种重要的需上报的性传播疾病。本文描述了21世纪00年代在昆士兰州开展的两项淋病强化监测项目的结果：一项在偏远的托雷斯和北半岛地区（T&NPA）；另一项在城市地区。T&NPA（2006 - 2011年）的总体响应率为82%（879例中的723例），布里斯班南区和西莫顿（BSWM）（2003 - 2011年）的响应率为62%（2401例通报中的1494例）。在T&NPA，病例多为年轻人（80%年龄小于25岁），原住民（97%），44%为男性。在BSWM，病例主要为男性（76%），非原住民（92%），42%年龄小于25岁。在托雷斯地区，54%的男性和60%的女性同时感染衣原体，在BSWM，18%的男性和35%的女性同时感染衣原体。在BSWM，未进行梅毒检测的男性中有35%报告与男性有性接触；同样，未进行艾滋病毒检测的男性中有34%报告与男性有性接触。除2008年（84%）外，T&NPA各年份对推荐治疗（头孢曲松）的依从率均高于90%。在BSWM队列中，治疗依从率从2003年的40%显著提高到2011年的84.4%（P<0.0001）。在建立了与临床医生的随访系统并成为常规操作后，T&NPA中记录有治疗日期的接触者比例从2009年的56%显著增加到2011年的76%（P = 0.019）。昆士兰州不同人群的淋病流行病学和管理挑战各不相同。强化监测使公共卫生当局能够监测流行病学情况，并提醒临床医生为其患者优先提供有效的性传播感染治疗。
