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Epididymitis rates in Australian hospitals 2009–2018: ecological analysis
  1. Jane L Goller1,
  2. Alysha M De Livera1,
  3. Basil Donovan2,3,
  4. Christopher K Fairley4,5,
  5. Nicola Low6,
  6. Jane S Hocking1
  1. 1Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  2. 2The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, New South Wales, Australia
  3. 3Sydney Sexual Health Centre, Sydney, New South Wales, Australia
  4. 4Central Clinical School, Monash University, Melbourne, Victoria, Australia
  5. 5Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
  6. 6Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
  1. Correspondence to Jane L Goller, Centre for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Melbourne, VIC 3053, Australia; jane.goller{at}unimelb.edu.au

Abstract

Objectives To investigate rates of acute epididymitis diagnosed in Australian hospital settings.

Methods Yearly hospital admission and emergency department (ED) rates of epididymitis as primary diagnoses were calculated for 15–44-year-old men for three states (Victoria, New South Wales, Queensland) from 2009 to 2014 using population denominators. Zero inflated Poisson regression models were used to analyse variation in rates by year, age, and residential area. Additionally, we investigated national epididymitis admission trends from 2009 to 2018 using generalised linear models.

Results Between 2009 and 2014, there was a total of 7375 admissions and 17 281 ED presentations for which epididymitis was the main reason for care. Most epididymitis diagnoses (94.0% in admissions, 99.7% in EDs) were without abscess, and 2.5% of admissions were for chlamydial epididymitis. Almost a quarter (23.3%) of epididymitis diagnosed in EDs resulted in hospital admission. In 2014, the epididymitis rate per 100 000 men was 38.7 in admissions and 91.9 in EDs. Comparing 2014 with 2009, the overall epididymitis diagnosis rate increased in admissions by 32% (adjusted incident rate ratio (aIRR) 1.32, 95% CI 1.20 to 1.44) and in ED attendances by 40% (aIRR 1.40, 95% CI 1.31 to 1.49). By age, the highest rates were among men 35–44 years in admissions and men 15–24 years in EDs. National admission rates of epididymitis during 2009–2018 showed a similar pattern.

Conclusion Rates of epididymitis diagnosis in hospital admission and ED presentations increased. Different age-related rates in these settings suggest a different aetiology or differential severity by age group.

  • chlamydia infection
  • epididymitis
  • gonorrhoea
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Footnotes

  • Handling editor Sevgi O Aral

  • Twitter @nicolamlow

  • Contributors JLG collected, cleaned and analysed the data, contributed to the analysis plan and drafted and revised the manuscript. AMDL provided statistical advice and contributed to the manuscript draft and revisions. JSH, CKF, BD and NL contributed to the interpretation of results and contributed to the manuscript draft and revisions. All authors approved the final submitted version of the manuscript.

  • Funding These data are being analysed as part of the Australian Chlamydia Control Effectiveness Pilot (ACCEPt) study funded by the Australian Government Department of Health and the National Health and Medical Research Council.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The Royal Australian College of General Practitioners National Research and Evaluation Ethics Committee approved the study (NREEC09.019).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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