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Geomapping of chlamydia and gonorrhoea in Birmingham
M Shahmanesh1, S Gayed, M Ashcroft
1Whittall Street Clinic, Birmingham. mohsen.shahmanesh@bscht.wmids.nhs.uk
Insights
Patients with genital chlamydia infections in urban settings are part of core populations. These groups share similar, though not identical, sociodemographic traits with individuals infected with gonorrhea.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- The core population hypothesis suggests that a small, sexually active group drives the transmission of sexually transmitted infections (STIs).
- Understanding the applicability of this hypothesis to genital chlamydia is crucial for targeted public health interventions.
- Previous research has primarily focused on gonorrhea, leaving chlamydia's core population dynamics less defined.
Purpose of the Study:
- To determine if the core population hypothesis applies to patients diagnosed with genital chlamydia.
- To compare the sociodemographic characteristics of chlamydia patients with those of gonorrhea patients and a control group.
- To identify predictors of chlamydia and gonorrhea infection within an urban population.
Main Methods:
- A retrospective cross-sectional study was conducted in genitourinary medicine (GUM) clinics in Birmingham and surrounding areas.
- Data included patients diagnosed with chlamydia (n=665) or gonorrhea (n=584) and a control group (n=727) from 1995-1996.
- Postcode analysis was used to determine population prevalence rates, estimate socioeconomic status (Super Profile - SP), and calculate ethnic-specific rates.
Main Results:
- Genitourinary medicine (GUM) clinic attendees represented a significant proportion of reported chlamydia (67.6%) and gonorrhea (82.5%) cases.
- Both infections were more prevalent in males and Black ethnic groups, with significantly higher rates in the Black population compared to White individuals.
- Younger age (<20 years), male sex, Black ethnicity, and lower socioeconomic status (SP J) were significant predictors for both infections.
Conclusions:
- Patients with genital chlamydia attending GUM clinics in a large urban setting represent core population groups.
- These core groups exhibit sociodemographic characteristics similar to, but not identical to, those infected with gonorrhea.
- The findings support the applicability of the core population hypothesis to chlamydia, informing STI control strategies.
Objective:
To investigate if the core population hypothesis is applicable to patients with genital chlamydia infections.
Design:
Retrospective cross sectional study.
Setting:
Two genitourinary medicine (GUM) clinics in the city of Birmingham and eight adjacent clinics.
Subjects:
All patients with chlamydia (n = 665) or gonorrhoea (n = 584) attending between 1 October 1995 and 30 September 1996 with a postcode within the Birmingham health district. Controls were 727 patients seen in the same period with no infection.
Methods:
Postcodes were used to calculate population prevalence rates per 100,000 aged 15-65 in the 39 wards of the city and to estimate the socioeconomic status using the Super Profile (SP). Ethnic specific rates were also calculated. Data were obtained on gonorrhoea and chlamydia isolation from all the major laboratories of the city over the same time period.
Results:
GUM clinic attenders accounted for 67.6% and 82.5% of all chlamydia and gonorrhoea isolates reported by the laboratories and that were available for our epidemiological analysis. Both infections were more common in men and in black ethnic groups. However, patients with gonorrhoea only infection were more likely to be of black ethnicity than those with chlamydia only infection (p = 0.0001) and to have different SP distribution (p = 0.0001). On logistic regression age < 20 years, male sex, black ethnicity, and living in neighbourhoods with SP J ("have nots") were predictive of both infections compared with controls. Overall chlamydia and gonorrhoea prevalence rates were 129 and 98.4 per 10(5) respectively. Corresponding rates for whites was 64.7 and 37.2 and for black ethnic groups 1105 and 1183 per 10(5) of each ethnic group. Eight adjacent wards accounted for 41% of the chlamydia and 66.5% of the gonorrhoea.
Conclusion:
In a large urban setting patients attending GUM clinics with chlamydia belong to core population groups with similar, but not identical, sociodemographic characteristics to patients with gonorrhoea infection.