Abstract
Although dengue has been a public health problem for several decades in the Lao People's Democratic Republic, the magnitude of the disease burden and epidemiological trends remain poorly understood. We analysed national dengue surveillance and laboratory data from 2006 to 2012 by person, place and time. Between 2006 and 2012, the annual dengue notification rate ranged between 62 and 367 cases per 100000 population with an apparent geographical expansion of transmission throughout the country in recent years and concurrent co-circulation of all four dengue virus subtypes. An electronic database, called Lao People's Democratic Republic Early Warning Alert and Response Network, was introduced in 2008 to provide automated early warning for outbreaks and epidemics. Village outbreaks continue to be notified primarily through event-based surveillance, whereas the weekly indicator-based system provides systematic assessment of annual epidemic cycles. The dengue case data indicate a high and increasing burden of disease. Efforts now need to focus on using available data to prompt more effective outbreak response and to guide the design and implementation of intervention strategies.
Highlights
Despite a high prevalence of sexually transmitted infections (STIs) in Pacific island countries and territories,[1,2,3,4] there are limited data on STIs and risk behaviour among men who have sex with men (MSM) and transgender people (TG)
While culturally defined TG roles for men exist throughout Pacific island countries and territories,[5] male-to-male sexual contact occurs among men who do not identify as TG or homosexual
In 2011, an Integrated Bio-Behavioural Survey of selfidentified MSM and TG was conducted by the Burnet Institute in partnership with Wan Smolbag and the Vanuatu Ministry of Public Health in Port Vila, Vanuatu
Summary
Respondent-driven sampling (RDS) was used to recruit participants between November 2011 and April 2012. Biological men, identifying as male or transgender women, and aged over 18 years who reported anal sex with another male in previous year were eligible. Interviews were conducted in the local language; the questionnaire included items about socio-demographics, sexual risk a Center for Population Health, Burnet Institute, Melbourne, Australia. Transmitted infections among transgender people and men who have sex with men, Vanuatu behaviours, previous diagnoses of any STI, prior STI symptoms and treatment-seeking behaviour. TG participants reported younger age at sexual debut compared to MSM (16 or younger (P < 0.05). The majority of participants reported sexual contact with a male partner during the past six months. Consistent condom use during anal sex was low across all regular, casual, paying and paid sexual partners (Table 1). Consistent condom use with recent female partners was low overall (Table 1).
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