Gonorrhea In China Research Articles

Interruption time series analysis using autoregressive integrated moving average model: evaluating the impact of COVID-19 on the epidemic trend of gonorrhea in China

BackgroundInterrupted time series (ITS) analysis is a growing method for assessing intervention impacts on diseases. However, it remains unstudied how the COVID-19 outbreak impacts gonorrhea. This study aimed to evaluate the effect of COVID-19 on gonorrhea and predict gonorrhea epidemics using the ITS-autoregressive integrated moving average (ARIMA) model.MethodsThe number of gonorrhea cases reported in China from January 2005 to September 2022 was collected. Statistical descriptions were applied to indicate the overall epidemiological characteristics of the data, and then the ITS-ARIMA was established. Additionally, we compared the forecasting abilities of ITS-ARIMA with Bayesian structural time series (BSTS), and discussed the model selection process, transfer function, check model fitting, and interpretation of results.ResultDuring 2005–2022, the total cases of gonorrhea were 2,165,048, with an annual average incidence rate of 8.99 per 100,000 people. The highest incidence rate was 14.2 per 100,000 people in 2005 and the lowest was 6.9 per 100,000 people in 2012. The optimal model was ARIMA (0,1, (1,3)) (0,1,1)12 (Akaike’s information criterion = 3293.93). When predicting the gonorrhea incidence, the mean absolute percentage error under the ARIMA (16.45%) was smaller than that under the BSTS (22.48%). The study found a 62.4% reduction in gonorrhea during the first-level response, a 46.47% reduction during the second-level response, and an increase of 3.6% during the third-level response. The final model estimated a step change of − 2171 (95% confidence interval [CI] − 3698 to − 644) cases and an impulse change of − 1359 (95% CI − 2381 to − 338) cases. Using the ITS-ARIMA to evaluate the effect of COVID-19 on gonorrhea, the gonorrhea incidence showed a temporary decline before rebounding to pre-COVID-19 levels in China.ConclusionITS analysis is a valuable tool for gauging intervention effectiveness, providing flexibility in modelling various impacts. The ITS-ARIMA model can adeptly explain potential trends, autocorrelation, and seasonality. Gonorrhea, marked by periodicity and seasonality, exhibited a downward trend under the influence of COVID-19 intervention. The ITS-ARIMA outperformed the BSTS, offering superior predictive capabilities for the gonorrhea incidence trend in China.

Analysis and prediction of the incidence and prevalence trends of gonorrhea in China

ABSTRACT To understand the epidemiological trend of gonorrhea in China from 2004 to 2021, predict the prevalence of the disease, and provide basic theory and data support for monitoring and managing gonorrhea. Gonorrhea incidence data in China from 2004 to 2021 were collected through the China Public Health Science Data Center and National Administration of Disease Prevention and Control, and the incidence and epidemiological characteristics were analyzed. Statistical analysis was performed using Joinpoint and autoregressive integrated moving average (ARIMA) models. A linear correlation model was used to analyze the correlation between gross domestic product (GDP) and the incidence rate. From 2004 to 2021, a total of 2,289,435 cases of gonorrhea were reported in China, with an average reported incidence rate of 9.46/100,000 people and a downward followed by an upward trend. Individuals with gonorrhea were primarily 20–30 y of age, with 1,034,847 cases (53.38%) from 2004 to 2018. The trend of increasing incidence was most obvious in the 10–20 age group (5,811 cases in 2004 to 12,752 cases in 2018, AAPC = 6.1, P < .001). The incidence of gonorrhea in China was negatively correlated with GDP from 2004 to 2021 (r = -0.547, P = .019). The correlation coefficient between the average incidence growth rate of each region from 2012 to 2018 and the average growth rate of regional GDP was 0.673 (P < .01). The root mean square error (RMSE) of the ARIMA model was 4.89%, showing powerful performance. There would be 97,910 gonorrhea cases in 2023 as predicted by the model.

Impact of COVID-19 pandemic on the epidemiology of STDs in China: based on the GM (1,1) model

BackgroundCOVID-19 and Sexually Transmitted Diseases (STDs) are two very important diseases. However, relevant researches about how COVID-19 pandemic has impacted on the epidemiological trend of STDs are limited in China. This study aimed to analyze the impact of COVID-19 on STDs in China and proposed relevant recommendations to be used in bettering health.MethodsThe incidence of HIV infection, syphilis and gonorrhea in China from 2008 to 2020 were collected. Grey Model (1,1) were established to predict the incidence of STDs with the incidence data of these three STDs from 2013 to 2018 considering the impact of policies in China, respectively. We then calculated the predictive incidence of each STD in 2019, 2020 and 2021 by the established Model. And we estimated the extent of the impact of COVID-19 on the epidemiological changes of STDs by analyzing the difference between the absolute percentage error (APE) of the predictive incidence and actual rate in 2019 and 2020.ResultsThe incidence of HIV infection and syphilis showed a trend of increase from 2008 to 2019 in China, but that for gonorrhea was fluctuant. Of note, the incidence of these three STDs decreased significantly in 2020 compared with that in 2019. The APE of HIV infection, syphilis and gonorrhea in 2020 (20.54%, 15.45% and 60.88%) were about 7 times, 4 times and 2 times of that in 2019 (2.94%, 4.07% and 30.41%). The incidence of HIV infection, syphilis and gonorrhea would be 5.77/100,000, 39.64/100,000 and 13.19/100,000 in 2021 based on our model.ConclusionsThe epidemiological trend of STDs in China was significant influenced by COVID-19 pandemic. It is important to balance the control of COVID-19 and timely management of STDs during the COVID-19 epidemic to prevent or reduce the poor outcome among COVID-19 patients with STDs. New management strategies on STDs, such as leveraging social media, online medical care, rapid self-testing, timely diagnosis and treatment guarantee and balance of medical resources for STDs management should be adapted in the context of the long-term effects of COVID-19.

Epidemiological characteristics of gonorrhea and its influential meteorological factors: a 14-year retrospective assessment in China.

This study aimed to investigate the seasonal variation of gonorrhea in China, and to analyze the relationship between the incidence of gonorrhea and meteorological factors.Data from gonorrhea cases were obtained from the Disease Prevention and Control Bureau and the Data-Center for China Public Health Science, Chinese Center for Disease Control and Prevention, and the incidence of gonorrhea in China from 1 January 2006 to 31 December 2019 was analyzed. Meteorological data from the same period were obtained from the South China Meteorological Data Sharing Center, including the average monthly temperature, relative humidity, atmospheric pressure, sunshine hours, number of rainy days,and precipitation. The ratio-to-moving average method and seasonal subseries plots were used to analyze the seasonality of gonorrhea cases. The distributed lag non-linear model and attribution risks were used to investigate the effects of meteorological indexes on gonorrhea cases.The number of gonorrhea cases showed seasonal variation, with a peak in the third quarter and a decline in the first quarter. The Spearman assay showed that the reported number of patients with gonorrhea was positively correlated with the monthly temperature, relative humidity, precipitation, and number of rainy days. The risk of gonorrhea onset was highest at 6-11°C, and the highest risk occurred when the average monthly temperature was 7°C (resulting in an increase of 14.5% compared with 13°C); a similar result was found regarding the cumulative risk of gonorrhea onset in relation to temperature. The attribution score of temperature to the onset of gonorrhea was 5.02% (95% confidence interval: - 3.84%, 13.88%).The study findings suggest that increased emphasis should be placed on screening for gonorrhea during summer and autumn, and that education on safe sexual behavior should be promoted during these times.

Does Urbanization Increase the Risk of Emerging Infectious Diseases in China? A Spatial Econometric Analysis

The current COVID-19 pandemic has inspired more and more discussion about the relationship between urbanization and emerging infectious diseases (EID). This paper aims to examine the spatial effect of urbanization on EID incidence, such as hepatitis, syphilis and gonorrhea in China. Taking into account geographical and economic factors, the estimation results of the Spatial Error Model (SEM) show that urbanization has increased the risks of EID transmission from 2003 to 2019 in China. The spatial effects of urbanization are slightly different due to different types of infectious diseases, with a larger effect on syphilis comparing with hepatitis and gonorrhea. The regional heterogeneity test shows that the impact of urbanization on EID in eastern China is stronger than that in the Midwest especially when considering spatial correlation. Policy implications that include health must be integrated into urban planning, attaching more importance to ecological construction, improving regional joint prevention and control mechanisms, and more attention being paid to vulnerable groups. Considering the frequent occurrence of COVID-19 among cities in China, we emphasize the importance of enhancing the coordinated anti-crisis capacity of urban clusters and highlight the leading role of central cities.

Advances in research on the resistance mechanism of &amp;lt;italic&amp;gt;Neisseria gonorrhoeae&amp;lt;/italic&amp;gt;

Gonorrhea is a sexually transmitted disease caused by Neisseria gonorrhoeae infection. Its prevalence and spread have become a huge burden on global public health. Antimicrobial therapy is currently the main method for the prevention and treatment of gonorrhea. However, with the widespread use of antibacterial agents in clinical practice, the resistance of N. gonorrhoeae has become an increasingly serious problem. Exploration of the resistance mechanism of N. gonorrhoeae is essential for improving its resistance monitoring system and adjusting the antimicrobial treatment regimens. We reviewed the recent advances in research on the resistance mechanism of N. gonorrhoeae , aiming to provide reference for the prevention and treatment of gonorrhea in China.

Enhancing gonorrhea surveillance in China by testing females in gynecology clinics: Lessons learned from a pilot survey.

ObjectivesChina has a high burden of gonorrhea, but an imbalanced male-to-female (M/F) ratio of reported cases. Therefore, the prevalence of gonorrhea in China may be underestimated due to inadequate testing of potentially infected females. The objective of this study is to investigate the cause of this imbalanced M/F ratio and develop strategies to enhance gonorrhea surveillance, particularly among females.MethodsThe national center for STD control (NCSTDC) of China CDC collected data in Zhongshan city over the year 2018 from the National Notifiable Disease Report System (NNDRS) and the Hospital and Laboratory Information Systems (HIS and LIS) that obtains information from 24 hospitals.ResultsAnalysis of 1,542 reported cases of gonorrhea and the case distribution among different hospitals showed that most of the female cases (80.31%) were reported by gynecological clinics. The M/F ratio of reported cases varied between different hospitals and was dependent on the intensity of testing of females by their gynecological clinics.ConclusionsThis study showed a significant correlation between M/F ratios and the relative contribution of female gonorrhea testing, especially in gynecology clinics. Enhancing gonorrhea testing among females should be advocated to improve surveillance in China.

National Guidelines on Diagnosis and Treatment of Gonorrhea in China (2020)#

Abstract Gonorrhea is one of the main sexually transmitted diseases in China. It mainly affects the genitourinary tract, and its clinical manifestations vary from asymptomatic to complicated types. The diagnosis of gonorrhea should be based on the patient's epidemiological history, clinical manifestations, and laboratory examination results. Treatment should be prompt and standardized and should involve the recommended treatment regimens. Patients should be appropriately followed up after treatment. The antimicrobial resistance of gonococcal isolates has become a severe problem of clinical concern. In order to provide technical guidance of the diagnosis and treatment of gonorrhea for health care workers, the authors developed the guidelines based on the version of 2014, which will be of important in the standardizing medical care of gonorrhea, and further facilitating control and prevention of the disease.

Using Baidu search index to monitor and predict newly diagnosed cases of HIV/AIDS, syphilis and gonorrhea in China: estimates from a vector autoregressive (VAR) model

ObjectivesInternet search engine data have been widely used to monitor and predict infectious diseases. Existing studies have found correlations between search data and HIV/AIDS epidemics. We aimed to extend the...

Widespread Use of High-Dose Ceftriaxone Therapy for Uncomplicated Gonorrhea Without Reported Ceftriaxone Treatment Failure: Results From 5-Year Multicenter-Surveillance Data in China

Abstract Background Antimicrobial resistance (AMR) to N gonorrhoeae has emerged for each of the antibiotics following their introduction into clinical practice recommended as first-line therapies. To improve rational and effective clinical antibiotic treatment, we analyzed the prescription patterns of antibiotics and its therapeutic effect in the treatment of uncomplicated gonorrhea in China. Methods We obtained data from a follow-up multicenter surveillance program. Multinomial logistic regression analyses were conducted to explore the associations between demographic/clinical variables with the levels of sensitivity to ceftriaxone and prescription of high-dose ceftriaxone. Results In this study, 1,686 patients infected with N gonorrhoeae were recruited in a surveillance network during the period of January 1, 2013, through December 31, 2017, in seven hospitals distributed in five provinces. The prevalence of isolates with decreased susceptibility to ceftriaxone was 9.8% (131/1333), fluctuating between 5.6% and 12.1%. Injectable ceftriaxone was chosen as the first-line treatment among 83.1% patients, and most of them (72.7%, 1,018/1,401) received more than a 1,000-mg dosage. Patients who were infected with gonorrhea or infected with other STDs before (AOR 1.611, 95% CI [1.103-2.352]; AOR 2.329, 95% CI [1.553-3.494]) or who used already antibiotics for this infection (AOR 1.597, 95% CI [1.04-2.452]) were associated with higher prescribed ceftriaxone dosage prescribed. All of the patients recruited in this study were cured regardless of the isolates’ susceptibility to ceftriaxone or the dosage of ceftriaxone they received. Conclusions No failure treatment for uncomplicated gonorrhea was reported in China; however, high-dose ceftriaxone was widely used in China, and its impacts need further studies.

Gonorrhea in China, 2018

Abstract Objective: Gonorrhea is a globally widespread sexually transmitted infection caused by Neisseria gonorrhoeae. This study is aimed to analyze the epidemiological characteristics of gonorrhea cases reported in China in 2018 and provide evidence for strategies making in the gonorrhea prevention and control programme. Methods: Gonorrhea cases were extracted from National Notifiable Disease Report System (NNDRS) covering 31 provinces, autonomous regions, and municipalities in the mainland of China. The overall incidence rate was calculated, as were rate per province, sex, age group, and occupation group. Results: In 2018, 133,156 new cases of gonorrhea were reported in China, corresponding to an incidence rate of 9.59 cases per 100,000 population and having a 36.03% increase from 2014 (7.05 cases per 100,000 population). Zhejiang, Hainan, Guangdong, Fujian provinces, and Shanghai city had a higher reported rate (14.05-28.00 per 100,000 population). Hebei, Tianjin, Tibet, Heilongjiang, and Jilin provinces had a lower reported rate (1.56-5.19 per 100,000 population). The males had a much higher incidence than the females (15.81 per 100,000 vs. 3.08 per 100,000) and a faster rising rate (38.32% vs. 27.27%). The highest rate was detected in the aged 25–29 years both of male and female (46.37 and 6.60 per 100,000, respectively), followed by those aged 30–34 years (41.12 and 6.39 per 100,000, respectively). The largest proportion of gonorrhea cases was among the farmers accounting for 27.74%, followed by the unemployed persons (24.67%), business persons (17.02%) and industrial workers (9.50%). Conclusion: In general, gonorrhea has an increasing trend from 2014 and remains a common notifiable disease in China in 2018. Young males who are sexually active are high risk populations for gonococcal infection. The southeast coastal areas with developed economy have a higher rate of gonorrhea reported. Corresponding strategies on disease prevention and control should be performed on the high risk populations and regions.

Nonadherence to National Guidelines for Antibiotic Treatment of Uncomplicated Gonorrhea in China: Results From a Nationwide Survey.

Provider adherence to the national treatment guidelines for gonorrhea is critical to assuring effective treatment. It is also an important means of limiting antibiotic overuse, which can lead to development of resistant bacteria. The Chinese treatment guidelines recommend the monotherapy with ceftriaxone or spectinomycin in accordance with the World Health Organization guidelines for treatment of uncomplicated gonorrhea. We evaluated adherence to the guidelines among treatment providers in China. The study was a nationwide cross-sectional study. In each of the 6 geographic regions in China, at least 1 province was selected. In each selected province, cities with elevated incidence of reported gonorrhea were purposively selected. Using a questionnaire, 2121 physicians recruited from 512 different categories and levels of health sectors from July to September 2017 were investigated. Of the participants, more than 99% diagnosed gonorrhea using one of the laboratory tests including Gram stain, culture, nucleic acid amplification test, or other tests. Culture was the predominant assay of the choice for the diagnosis. Of the 1890 physicians who provided information on prescription behaviors, 62.2% were not adherent to the regimens for treatment of uncomplicated gonorrhea recommended by the National Sexually Transmitted Disease (STD) Treatment Guidelines (National STD Guidelines). Physicians working in the areas located in Northern China (adjusted odds ratio [AOR], 3.06; 95% confidence intervals [CIs], 1.77-5.31), in general hospitals or departments of urology (AOR, 1.54; 95% CIs, 1.08-2.19), diagnosing more cases in the past 6 months (AOR, 1.82; 95% CIs, 1.25-2.67), or unfamiliar with the treatment regimens in the National STD Guidelines (AOR, 3.48; 95% CIs, 2.76-4.37) were significantly more likely to be nonadherent to the National STD Guidelines. It can be concluded from our study that nonadherence to the national guidelines and empirical treatment with high doses of ceftriaxone occurred frequently in China. Further studies on the impacts of the empirical treatment on antimicrobial resistance of gonorrhea are needed.

Epidemiological characteristics and trends of gonorrhea in China from 2000 to 2014

Objective To investigate epidemiological characteristics and trends of gonorrhea in China, and to provide a scientific basis for the development of control strategies. Methods An epidemiological study was performed on gonorrhea cases reported from 31 provinces, autonomous regions or municipalities directly under the central government between 2000 and 2014. Results The reported incidence rate of gonorrhea decreased from 22.92 per 100 000 in 2000 to 7.25 per 100 000 in 2014, with the average annual rate of decrease being 7.89%. There was a significant difference in the incidence of gonorrhea between different regions. The regions with the highest incidence rate of gonorrhea were Yangtze River Delta region (Zhejiang, Shanghai, Jiangsu) and Zhujiang River Delta region (Guangdong, Guangxi, Hainan), followed by northwest China (Xinjiang, Ningxia, Inner Mongolia). The incidence of gonorrhea was higher in males than in females, and the average male/female ratio increased from 1.96∶1 in 2000 to 4.52∶1 in 2014. The population aged 20-44 years showed high incidence of gonorrhea, and the highest incidence rate of gonorrhea was observed in the age group 25-29 years in both men and women. The incidence of gonorrhea decreased in all the age groups from 2000 to 2014 except the age group 15-19 years with an annual growth rate of 4.18%. Of 20 occupations, peasant workers accounted for the highest proportion (26.00%) of reported gonorrhea cases, and the number of reported gonorrhea cases showed a decreasing trend in all the occupations. Conclusions Gonorrhea remains a major public health issue in China, and effective measures based on epidemiological features are urgently needed to control gonorrhea. Key words: Gonorrhea; Epidemiologic study characteristics as topic; Incidence; China; Trends

Different types of backward bifurcations due to density-dependent treatments

A set of deterministic SIS models with density-dependent treatments are studied to understand the disease dynamics when different treatment strategies are applied. Qualitative analyses are carried out in terms of general treatment functions. It has become customary that a backward bifurcation leads to bistable dynamics. However, this study finds that finds that bistability may not be an option at all; the disease-free equilibrium could be globally stable when there is a backward bifurcation. Furthermore, when a backward bifurcation occurs, the fashion of bistability could be the coexistence of either dual stable equilibria or the disease-free equilibrium and a stable limit cycle. We also extend the formula for mean infection period from density-independent treatments to density-dependent ones. Finally, the modeling results are applied to the transmission of gonorrhea in China, suggesting that these gonorrhea patients may not seek medical treatments in a timely manner.