Abstract

In Samoa, the seroprevalence rates of sexually transmitted infections other than HIV have been endemically high over the past decade, despite years of prevention programming. Odds ratio and χ2 tests were conducted to compare the rates of positivity of chlamydia, gonorrhoea, hepatitis B and C, and syphilis across age groups from 2012 and 2017 surveillance data in Samoa. Young people aged 15–19 years were significantly more likely to have a chlamydia infection compared to all other age groups in both 2012 and 2017. Hepatitis B infections were more common in males and those aged 30 and above in both 2012 and 2017. Hepatitis C had no significant differences in age, but it was more common in males in 2012 and more common in females in 2017. Older age groups (aged 45 and above) were more likely to have a positive syphilis test in both 2014 and 2017 when compared to those aged 15–24 years. The results of this analysis confirm previously observed trends in Samoa for younger age groups’ prevalence of chlamydia and gonorrhoea, and for older age groups’ prevalence of hepatitis B and C. But the analysis also unexpectedly found that older age groups (aged 45 and above) are more likely to test positive for syphilis (for years 2014 and 2017). Further studies are needed to assess behavioural risk factors associated with older populations to explain the increase in risk and to design interventions suited to this demographic.

Highlights

  • The 2017 national positivity rates for chlamydia, gonorrhoea and syphilis (24.2%, 5.6% and 1.04%, respectively) are similar to previous prevalence rates.[8]

  • Data are comprised of all diagnostic testing that was recorded by the National Reference Laboratory (NRL) of Tupua Tamasese Meaole (TTM) Hospital, Apia

  • The assays used in the national testing algorithm include polymerase chain reaction (PCR) for chlamydia and gonorrhoea, rapid plasma reagin (RPR) and treponema pallidum haemagglutination (TPHA) tests for syphilis, hepatitis B surface antigen (HBsAg) tests for hepatitis B, the hepatitis C antibody test for hepatitis C

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Summary

Introduction

The 2017 national positivity rates for chlamydia, gonorrhoea and syphilis (24.2%, 5.6% and 1.04%, respectively) are similar to previous prevalence rates.[8] This suggests a persistently high prevalence of STIs, chlamydia, for the past decade. Samoa has previously reported the lowest rate of syphilis worldwide (0%).[8] syphilis has increased globally among heterosexuals and men who have sex with men.[8] In Samoa, syphilis cases have steadily increased from 26 reported cases in 2015 to 78 cases in 2017.6. Age and sex trends of sexually transmitted infections in Samoa, 2012 and 2017 surveillance data, this analysis seeks to update the status of the epidemic by comparing positivity rates among sex and age groups from years 2012 and 2017

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