title: Prevalence of chlamydia, gonorrhoea, syphilis and trichomonas in Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis.
abstract: Higher notification rates of sexually transmissible infections (STIs) are reported among Aboriginal and Torres Strait Islander (Aboriginal) compared with non-Aboriginal people in Australia. The aim of this study is to estimate the pooled prevalence of chlamydia, gonorrhoea, syphilis and trichomonas among Aboriginal people in Australia by sex, age-group, setting (clinic vs population/community-based) and population group [adults, pregnant females, young people (12-29 years) and prisoners]. The databases Medline, PubMed and Web of Science were searched in May 2015. A meta-analysis was conducted to estimate the pooled prevalence of the four STIs in Aboriginal people and if possible, by gender, age-group, setting and population group. A total of 46 studies were included. The pooled prevalence was 11.2% (95%CI: 9.4-13.0%) for chlamydia (36 studies), 12.5% (95%CI: 10.5-14.6%) for gonorrhoea (28 studies), 16.8% (95%CI: 11.0-22.6%) for syphilis (13 studies) and 22.6% (95%CI: 18.5-26.7%) for trichomonas (11 studies); however, there was significant heterogeneity between studies (I(2) <97.5%, P<0.01). In the subgroup analysis, a higher pooled prevalence occurred in females than males for chlamydia (12.7% vs 7.7%) and gonorrhoea (10.7% vs 8.1%). The prevalence of chlamydia was 12.4% in clinic-based compared with 4.3% in population-based studies. The highest pooled prevalence by population group was among pregnant females (16.8%) and young people (16.2%) for chlamydia, pregnant females (25.2%) for trichomonas; and young people for gonorrhoea (11.9%). This review highlights the need to decrease the prevalence of STIs among Aboriginal people through community-based programs that target asymptomatic young people.
authors.affiliation: Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Vic. 3052, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Graham
authors.affiliation: Kirby Institute, UNSW Australia, Sydney, NSW 2052, Australia.
authors.forename: Lucy Watchirs
authors.initials: LW
authors.lastname: Smith
authors.affiliation: Melbourne Sexual Health Centre and Central Clinical School, Monash University, 580 Swanston Street, Carlton, Vic. 3053, Australia.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
authors.affiliation: Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Vic. 3052, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Hocking
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002689:Chlamydia; D002690:Chlamydia Infections / Q000208:ethnology*; D005260:Female; D006069:Gonorrhea / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D013587:Syphilis / Q000208:ethnology*; D014244:Trichomonas; D014245:Trichomonas Infections / Q000208:ethnology*; D055815:Young Adult; D000095283:Australian Aboriginal and Torres Strait Islander Peoples