Abstract
Objectives
We aimed to identify demographic and behavioural determinants associated with risk of repeat STI infection and coinfection with gonorrhea and chlamydia in the Regina Qu’Appelle Health Region, Saskatchewan.
Methods
We extracted data from a cross-sectional sample of laboratory-confirmed gonorrhea cases between 2003 and 2012 from the notifiable disease files of the Regina Qu’Appelle Health Region. Risk factors for repeater status were examined using logistic regression and for coinfection with gonorrhea and chlamydia using mixed-effects logistic regression to account for multiple diagnoses for individual clients.
Results
Data from 1,143 cases (representing 1,027 unique individuals) and 1,524 reported contacts (representing 1,383 unique individuals) were extracted from the 10-year period. Factors associated with repeat infection entries in the database included younger age at first visit (p = 0.01), coinfection (p = 0.01), and sex trade involvement (p < 0.01). Factors associated with coinfection at the time of diagnosis included younger age at diagnosis (p < 0.001) and reported alcohol or drug abuse (p = 0.04).
Conclusion
In one of the first epidemiologic studies on gonorrhea in Saskatchewan, we have identified age, engagement in the sex trade, and drug and alcohol abuse as potential markers to identify clients with a high risk of reinfection and coinfection in the Regina Qu’Appelle Health Region. This information can help health care professionals in Saskatchewan’s urban centres personalize their approach to counselling and treatment to optimize patient outcomes and disease control efforts, including potentially using expedited partner therapy and/or dual therapy where indicated.
Key Words: Gonorrhea, sexually transmitted diseases, risk factors, coinfection, chlamydia
ésumé
Objectifs
Notre but était d’identifier les déterminants démographiques et comportementaux associés au risque d’infection sexuellement transmissible répétée et de coïnfection par la gonorrhée et la chlamydiose dans la région sanitaire de Regina Qu’Appelle (Saskatchewan).
Méthode
Nous avons extrait des dossiers des maladies à déclaration obligatoire de la région sanitaire de Regina Qu’Appelle les données d’un échantillon transversal de cas de gonorrhée confirmés en laboratoire survenus entre 2003 et 2012. Les facteurs de risque d’infection répétée ont été examinés par régression logistique, et les facteurs de coïnfection par la gonorrhée et la chlamydiose, par régression logistique à effets mixtes, afin d’expliquer les diagnostics multiples sur une base individuelle.
Résultats
Les données de 1 143 cas (représentant 1 027 personnes distinctes) et de 1 524 contacts déclarés (représentant 1 383 personnes distinctes) ont été extraites sur la période d’étude de 10 ans. Les facteurs associés aux infections répétées dans la base de données étaient le jeune âge à la première visite (p = 0,01), la coïnfection (p = 0,01) et la participation au commerce du sexe (p < 0,01). Les facteurs associés à la coïnfection lors du diagnostic étaient le jeune âge au diagnostic (p < 0,001) et l’abus d’alcool ou de drogue déclaré (p = 0,04).
Conclusion
Dans cette étude, qui est l’une des premières études épidémiologiques sur la gonorrhée en Saskatchewan, nous avons identifié l’âge, la participation au commerce du sexe et l’abus de drogue et d’alcool comme étant des marqueurs potentiels pour identifier les clients présentant un risque élevé de réinfection et de coïnfection dans la région sanitaire de Regina Qu’Appelle. Cette information peut aider les professionnels de la santé des centres urbains de la Saskatchewan à personnaliser leurs approches de counseling et de traitement pour optimiser leur effet sur les patients et les efforts de lutte contre les maladies, potentiellement en utilisant la thérapie accélérée pour les partenaires et/ou la bithérapie, selon le cas.
Mots Clés: gonorrhée, maladies sexuellement transmissibles, facteurs de risque, coïnfection, chlamydia
Footnotes
Conflict of Interest: None to declare.
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