Gonorrhoea Remains High In Auckland

THE number of gonorrhoea cases reported in Auckland remains high and increased 10 percent over the past year. However, Waikato and Bay of Plenty figures for gonorrhoea have fallen over the past six months, according to the latest surveillance reports.

The reports by Environmental and Scientific Research Limited (ESR) , commissioned by the Ministry of Health as part of its Sexually Transmitted Infections surveillance programme, show that high levels of gonorrhoea have continued in Auckland over the July to December 2000 period. Initial figures for January 2001 show no sign of a decline in the upward trend of recent years.

Ministry of Health Senior Public Health Medicine Advisor Dr Alison Roberts said the continued increase in the rate of sexual infections was concerning.

"The figures show people are not having safe sex. It highlights the need to use condoms. People must remember that infections such as gonorrhoea and chlamydia may be symptomless and that partners also need to be tested and treated," Dr Roberts said.

Auckland laboratories reported 669 cases of gonorrhoea in 2000, which is 10 percent higher than the 606 cases reported in 1999, up 50 percent from the 445 cases reported in 1998 and 117 percent higher than the 308 cases reported in 1997. The laboratories reported 71 cases of gonorrhoea for January 2001, the second highest monthly figure since the increase in gonorrhoea was first observed in late 1997.

For the six-month July to December 2000 period, Auckland laboratories reported 311 cases of gonorrhoea, compared with 358 cases for the January to June 2000 period.

The overall incidence of gonorrhoea in Auckland for the July to December 2000 period was 58 cases per 100,000 people. The rate of gonorrhoea was higher in men (64 per 100,000) than in women (51 per 100,000). However, the proportion of gonorrhoea reported in Auckland women had increased from 37 percent of cases to 45 percent of all cases. Women aged 15-19 years had the highest rate (282 per 100,000), followed by men aged 20-24 years (267 per 100,000). Two thirds of cases (202) were in people younger than 25 and of eight cases were in people under 15. There were two cases of gonorrhoea in infants under 12 months old.

Waikato and Bay of Plenty laboratories reported a total of 280 gonorrhoea cases in 2000, 10 percent more than the 254 cases reported in 1999. However there was a substantial decrease in gonorrhoea cases over the second half of 2000. For the July to December 2000 period, Waikato and Bay of Plenty laboratories reported 104 cases of gonorrhoea, 41 percent lower than the 176 cases reported for the previous six month period.

The overall incidence of gonorrhoea in the Waikato and Bay of Plenty for the July to December 2000 was 37 cases per 100,000 people. In contrast with Auckland, the incidence of gonorrhoea was higher in females (41 per 100,000) than in males (33 per 100,000). Women aged 20-24 years had the highest rate (194 per 100,000) followed by women aged 15-19 years (149 per 100,000) and men aged 20-24 years (132 per 100,000). Fifty eight percent of gonorrhoea cases (60 people) in Waikato and Bay of Plenty were in people younger than 25 and three cases were in people under 15.

Waikato and Bay of Plenty laboratories reported a total number of 2812 chlamydia cases in 2000, up 15 percent from the 2447 cases reported in 1999. The increase in chlamydia between 1999 and 2000 is most likely due to the introduction of more sensitive DNA amplification test methods by laboratories, rather than being an increase in the incidence of chlamydia. Waikato and Bay of Plenty laboratories reported 1385 chlamydia cases between July and December 2000, slightly lower than the 1427 chlamydia cases reported for the previous six months.

The overall incidence of chlamydia in the Waikato and Bay of Plenty for the July to December 2000 period was 494 per 100,000. The rate of chlamydia was higher in females (708 per 100,000) than in males (267 per 100,000). The highest rates of chlamydia for the July to December 2000 period were in females aged 15-19 years (3,859 cases per 100,000 people) and females aged 20-24 years (3,731 per 100,000). Chlamydia rates are higher for females than males because women are more likely to be tested than men.

The Ministry and a group of independent experts are developing a comprehensive sexual and reproductive health strategy. Among key issues to be addressed are reducing and preventing sexually transmissible infections, reducing and preventing adolescent pregnancy, and reducing and preventing unintended pregnancy.

The first draft of the sexual and reproductive health strategy is expected to be completed by the middle of the year and the Ministry will then consult with the health and education sectors, government agencies, Pacific, Maori and young people before finalising the strategy by the end of August.

ENDS

For further interpretation of the data contact; Anne McNicholas, ESR Research Associate, 04-914-0693

For further information contact; Angus Barclay, Ministry of Health Media Advisor, 04-496-2067 Internet Address; http://www.moh.govt.nz

For local comment contact: Rick Franklin, Auckland Sexual Health Clinic, telephone 09-307-2885 or 021-988-365 Kitty Flannery, Waikato Sexual Health Clinic, telephone 07-839-8732 Noeleen Tanner, Tauranga Sexual Health Clinic, telephone 07-579-8130

Backgrounder: Auckland, Waikato and Bay of Plenty Chlamydia and Gonorrhoea Reports

The Ministry of Health commissions the Institute of Environmental Science and Research (ESR) to monitor sexually transmitted infections. This is done through a number of surveillance programmes, including the collection of anonymised data on laboratory confirmed cases of chlamydia and gonorrhoea in Auckland, and in Waikato and the Bay of Plenty.

The laboratory reports include positive chlamydia and gonorrhoea test results for patients seen by all health providers in the three regions - general practitioners, sexual health clinics, and family planning clinics.

While all laboratory-confirmed cases for a region are reported and this data provides a comprehensive source of information, the figures are likely to underestimate the real chlamydia and gonorrhoea rates because; patients may be treated for these infections without a laboratory test being undertaken chlamydia and gonorrhoea infections are often symptomless - particularly in women - so there will be untreated cases in the general population.

The laboratory reports are sent to surveillance programme participants and Medical Officers of Health so that they are aware of the rate of infection and trends in their local population. The Ministry and ESR would like to thank the programme participants for contributing to this increased awareness and information resource.

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