Investigating the state of our sexual health

Thursday, November 10, 2016

Dr Collette Bromhead from Massey University’s College of Health.

Investigating the state of our sexual health

A Massey University health scientist hopes to create more awareness about the prevalence, diagnosis and treatment for rare sexually transmitted infections in New Zealand.

College of Health senior lecturer in molecular microbiology Dr Collette Bromhead is presenting her work at the New Zealand Sexual and Reproductive Health and Rights Conference in Wellington this week.

The conference theme is ‘Improving Access and Advancing Equity’, and is the first joint meeting of Family Planning, New Zealand Sexual Health Society, and Abortion Providers Group Aotearoa New Zealand.

Under-diagnosed sexually transmitted infections in New Zealand

Dr Bromhead’s first piece of work is on Lymphogranuloma venereum (LGV) – a little known sexually transmitted disease caused by infection with a type of chlamydia (Chlamydia trachomatis) and not routinely tested for by New Zealand community laboratories.

Preliminary results from a recent Massey University study of 264 patients revealed 4.3 per cent of those found to have chlamydia in the Wellington region between 2012- 2015 were actually infected with the LGV serovar (a distinct variation within a species of bacteria).

Dr Bromhead says this prevalence is high compared to international studies. “Our results show a cluster of cases in 2013/2014 which suggests an outbreak of LGV at this time, in men who have sex with men. This is important because LGV cannot be treated by the same antibiotics usually used for chlamydia and if left untreated, could develop into severe bowel disease.”

She says this finding suggests testing for LGV should be more widely available in New Zealand and “in the meantime, clinicians should consider using 21 days of doxycycline to routinely treat rectal chlamydia infections.”

Dr Bromhead says the aim of the study was to use new commercial and research methods to test for LGV in a cohort of patients previously found to be infected with Chlamydia trachomatis in the throat, eye or rectum, to try to establish the New Zealand prevalence of this seemingly rare disease.

The anonymous DNA samples were tested using two different methods including a new test from SpeeDx Australia. The LGV positive samples now need confirmatory DNA sequencing, which will be carried out at Massey’s Genome Service on the Manawatū campus in the coming months.

The study was a Masters of Medical Laboratory Science project for Massey University student Savannah Young, who is being supervised by Dr Bromhead, Associate Professor Mary Nulsen and Chris Kendrick from Massey’s College of Health. The work is co-authored by Dr Michelle Balm from the Capital and Coast District Health Board and Dr Jane Kennedy from the Wellington Sexual Health Clinic.

Mycoplasma genitalium in New Zealand

Dr Bromhead’s second piece of work is on Mycoplasma genitalium (MG) – also a little known sexually transmitted infection, not currently tested by New Zealand community laboratories.

In the same cohort of 264 samples, research-based testing showed 5.3 per cent of Chlamydia positive patients were co-infected with MG in their throat, rectum or eye.

“While some of these infections may not cause symptoms, once identified all such cases should be treated. However, MG resistance to antibiotics has been reported overseas, and we are now planning to carry out tests to define how many New Zealand patients would have responded to the currently recommended antibiotic treatment,” Dr Bromhead says.

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