title: An analysis of underlying factors for seasonal variation in gonorrhoea in India: a 6-year statistical assessment.
abstract: OBJECTIVE
  A statistical assessment of a disease is often necessary before resources can be allocated to any control programme. No literature on seasonal trends of gonorrhoea is available from India.
  
  
  OBJECTIVE
  The objectives were (1) to determine, if any, seasonal trends were present in India (2) to describe factors contributing to seasonality of gonorrhoea (3) to formulate approaches for gonorrhoea control at the national level.
  
  
  METHODS
  Seasonal indices for gonorrhoea were calculated quarterly in terms of a seasonal index between 2005 and 2010. Ratio-to-moving average method was used to determine the seasonal variation. The original data values in the time-series were expressed as percentages of moving averages. Results were also analyzed by second statistical method i.e. seasonal subseries plot.
  
  
  RESULTS
  The seasonally adjusted average for culture-positive gonorrhoea cases was highest in the second quarter (128.61%) followed by third quarter (108.48%) while a trough was observed in the first (96.05%) and last quarter (64.85%). The second quarter peak was representative of summer vacations in schools and colleges. Moreover, April is the harvesting month followed by celebrations and social gatherings. Both these factors are associated with increased sexual activity and partner change. A trough in first and last quarter was indicative of festival season and winter leading to less patients reporting to the hospital.
  
  
  CONCLUSIONS
  The findings highlight the immediate need to strengthen sexual health education among young people in schools and colleges and education on risk-reduction practices especially at crucial points in the calendar year for effective gonorrhoea control.
authors: M
authors: M
authors: Kakran
authors: Apex Regional STD Teaching, Training and Research Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
authors: M
authors: M
authors: Bala
authors: V
authors: V
authors: Singh
mesh_terms: D006069:Gonorrhea / Q000453:epidemiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D015233:Models, Statistical; D012621:Seasons; D012725:Sexual Behavior