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Epidemiology and clinical presentation of gonorrhoea in England & Wales: Findings from the Gonococcal Resistance to Antimicrobials Surveillance Programme 2001-2006
  1. Valerie Delpech (valerie.delpech{at}hpa.org.uk)
  1. Health Protection Agency Centre for Infections, United Kingdom
    1. Iona M C Martin (imc.martin{at}btinternet.com)
    1. Health Protection Agency Centre for Infections, United Kingdom
      1. Gwenda Hughes (gwenda.hughes{at}hpa.org.uk)
      1. Health Protection Agency Centre for Infections, United Kingdom
        1. Tom Nichols (tom.nichols{at}hpa.org.uk)
        1. Health Protection Agency Centre for Infections, United Kingdom
          1. Laura James (laurajames50{at}hotmail.com)
          1. Health Protection Agency Centre for Infections, United Kingdom
            1. Catherine A Ison (catherine.ison{at}hpa.org.uk)
            1. Health Protection Agency Centre for Infections, United Kingdom

              Abstract

              Objective: To analyse the enhanced data for gonorrhoea cases in England and Wales collected by the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) to better inform health policy and targeted interventions.

              Methods: GRASP data obtained annually from sentinel GUM clinics between June to August during 2001-2006 were analysed.

              Results: A total of 12,282 cases of gonorrhoea were reported during the study period, with a decline over time primarily in heterosexual patients of black ethnicity. 73% of women, 47% of heterosexual men and 22% of MSM were aged under 25. Most infected women reported a single sexual partner in the previous 3 months, whereas most heterosexual men and MSM reported two or more partners. A history of gonorrhoea was reported by 42% of MSM, 30% of heterosexual men, and 20% of women. Excluding HIV, women were more likely than men to have a concurrent STI at diagnosis, most commonly Chlamydia (50% vs 27% p<0.0005).

              Rectal gonococcal infections were reported in 35% and HIV co-infection in 31% of MSM. Compared to HIV negative MSM, those co-infected with HIV were older (median 35 years vs 28 years) and were more likely to attend a London site (70% vs 52%, p<0.0005); have a concurrent STI (28% vs 20%, p=0.002); have a history of gonorrhoea (66% vs 36%, p<0.0005) and have more sexual partners (average 6.8 vs 4.3).

              Conclusion: Gonorrhoea is concentrated within specific groups who are at high risk of repeat infections and concurrent STIs including HIV. Targeted interventions of proven effectiveness are urgently required.

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