Objectives: To document the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in the refugee population settling in Western Australia from 1 January 2006 to 31 December 2009 and make recommendations for future screening for chlamydia and gonorrhoea in the refugee population.
Design and participants: A prevalence and quality assurance study of 2610 refugees aged 15 years and older who attended the Humanitarian Entrant Health Service in Western Australia and were screened for chlamydia and gonorrhoea.
Results: The prevalence of chlamydia was found to be 0.8% (n = 21) in the refugee population. No gonorrhoea infections were detected. The prevalence of chlamydia was low (0.19%–1.23%) when analysed by sex, ethnicity or age and was considerably lower than other subpopulations considered high risk in Australia.
Conclusion: The low prevalence rates of chlamydia and gonorrhoea found in the refugee population suggest that current screening guidelines should be updated. We recommend screening all refugees who are sexually active up to age 39 years, taking into account an appropriate sexual history; otherwise, screening guidelines should be as for the general Australian population.
- 1. World Health Organization. Global prevalence and incidence of selected curable sexually transmitted infections: overview and estimates. Geneva: WHO, 2001. http://www.who.int/hiv/pub/sti/who_hiv_aids_2001.02.pdf (accessed Feb 2012).
- 2. Murray R, Davis J, Krause V, et al; Australian Society for Infectious Diseases Writing Group. Diagnosis, management and prevention of infections in recently arrived refugees. Sydney: Dreamweaver Publishing, 2009. http://www.asid.net.au/images/Documents/Guidelines/RefugeeGuidelines.pdf (accessed Feb 2012).
- 3. Peipert JF. Clinical practice. Genital chlamydial infections. New Engl J Med 2003; 349: 2424-2430.
- 4. Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect 1999; 75: 3-17.
- 5. Sexual Health Society of Victoria. National management guidelines for sexually transmissible infections. Melbourne: SHSOV, 2008. http://mshc.org.au/Portals/6/NMGFSTI.pdf (accessed Feb 2012).
- 6. Australian Government Department of Immigration and Citizenship. Settlers by calendar year of arrival by age on arrival [internet database]. Canberra: DIC, 2010. http://www.immi.gov.au/living-in-australia/delivering-assistance/settlement-reporting-facility/ (accessed Jan 2010).
- 7. Walker J, Fairley CK, Bradshaw CS, et al. The difference in determinants of Chlamydia trachomatis and Mycoplasma genitalium in a sample of young Australian women. BMC Infect Dis 2011; 11: 35.
- 8. Hocking JS, Willis J, Tabrizi S, et al. A chlamydia prevalence survey of young women living in Melbourne, Victoria. Sex Health 2006; 3: 235-240.
- 9. Kang M, Rochford A, Johnston V, et al. Prevalence of Chlamydia trachomatis infection among ‘high risk’ young people in New South Wales. Sex Health 2006; 3: 253-254.
- 10. Buhrer-Skinner M, Muller R, Menon A, Gordon R. Novel approach to an effective community-based chlamydia screening program within the routine operation of a primary healthcare service. Sex Health 2009; 6: 51-56.
- 11. Watkins RE, Mak DB, Connelly C. Testing for sexually transmitted infections and blood borne viruses on admission to Western Australian prisons. BMC Public Health 2009; 9: 385.
- 12. Panaretto KS, Lee HM, Mitchell MR, et al. Prevalence of sexually transmitted infections in pregnant urban Aboriginal and Torres Strait Islander women in northern Australia. Aust N Z J Obstet Gynaecol 2006; 46: 217-224.
- 13. McDonagh P, Ryder N, McNulty AM, Freedman E. Neisseria gonorrhoeae infection in urban Sydney women: prevalence and predictors. Sex Health 2009; 6: 241-244.
- 14. Clift S, Anemona A, Watson-Jones D, et al. Variations of HIV and STI prevalences within communities neighbouring new goldmines in Tanzania: importance for intervention design. Sex Transm Infect 2003; 79: 307-312.
- 15. Kamali A, Quigley M, Nakiyingi J, et al. Syndromic management of sexually-transmitted infections and behaviour change interventions on transmission of HIV-1 in rural Uganda: a community randomised trial. Lancet 2003; 361: 645-652.
- 16. Ghazal-Aswad S, Badrinath P, Osman N, et al. Prevalence of Chlamydia trachomatis infection among women in a Middle Eastern community. BMC Womens Health 2004; 4: 3.
- 17. Siemer J, Theile O, Larbi Y, et al. Chlamydia trachomatis infection as a risk factor for infertility among women in Ghana, West Africa. Am J Trop Med Hyg 2008; 78: 323-327.
- 18. Pépin J, Deslandes S, Khonde N, et al. Low prevalence of cervical infections in women with vaginal discharge in west Africa: implications for syndromic management. Sex Transm Infect 2004; 80: 230-235.
- 19. Okoror LE, Agbonlahor DE, Esumeh FI, Umolu PI. Prevalence of chlamydia in patients attending gynecological clinics in south eastern Nigeria. Afr Health Sci 2007; 7: 18-24.
- 20. Australian Government Department of Immigration and Citizenship. Health requirement for permanent entry to Australia. Form 1071i. Canberra: DIAC, 2007. http://www.immi.gov.au/allforms/pdf/1071i.pdf (accessed Feb 2012)
- 21. Goulet V, de Barbeyrac B, Raherison S, et al; CSF group. Prevalence of Chlamydia trachomatis: results from the first national population-based survey in France. Sex Transm Infect 2010; 86: 263-270.
- 22. Australian Government Department of Immigration and Citizenship. Population flows: immigration aspects. Canberra: DIC, 2008. http://www.immi.gov.au/media/publications/statistics/popflows2006-7/title.pdf (accessed Feb 2012).
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.