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Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data Field Epidemiology Services, East Midlands Summary of 2015 data for East Midlands residents • Over 29,300 New STIs diagnosed • New STI diagnosis rate: 633 diagnoses per 100,000 population • Diagnoses of gonorrhoea fell by 1%, syphilis rose by 47% 2014 to 2015 • Chlamydia detection rate in those aged 15 to 24 was 1,835 per 100,000 pop. (aim = 2,300) • Diagnoses in GUM: 8% of new diagnoses in MSM (68% of syphilis) • 15 to 24 year olds accounted for 60% of New STI diagnoses • 3% of New STI diagnoses are in black Caribbeans who also have the highest rate (2,103 per 100,000 pop.) • White ethnic group has the highest numbers of New STIs (85% of total) • 90% of New STI diagnoses are in people born in the UK 2 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data Figure 1: New STI diagnosis per 100,000 population by PHE centre of residence, 2015 1,600.0 1,400.0 1,000.0 800.0 600.0 628.7 604.1 572.2 632.6 666.7 670.2 676.6 200.0 767.9 400.0 1,391.0 Rate per 100,000 population 1,200.0 South West South East East of England 0.0 London North West Yorkshire and Humber West North East East Midlands Midlands Source: Public Health England, GUMCAD (level 3 services) and CTAD. 3 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data Figure 2: Diagnoses of the five main STIs: East Midlands residents, 2011 to 2015 20,000 Number of diagnoses 18,000 16,000 15,957 15,415 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 5,663 4,846 2,191 1,960 229 2,348 1,079 171 2011 2012 2013 2014 Syphilis Gonorrhoea Chlamydia (pre-CTAD) Genital Herpes Genital Warts Chlamydia (CTAD) 2015 Any increase in gonorrhoea diagnoses may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in MSM. Any decrease in genital wart diagnoses may be due to a moderately protective effect of HPV-16/18 vaccination. Any increase in genital herpes diagnoses may be due to the use of more sensitive NAATs. Increases or decreases may also reflect changes in testing practices. Due to changes in 2012 to the surveillance of chlamydia, comparisons to previous years are not robust. Source: Public Health England, GUMCAD (level 3 services) and CTAD. 4 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data Figure 3: Diagnosis rates of the five main STIs: East Midlands residents, 2011 to 2015 Rate per 100,000 population 450.0 400.0 350.0 351.7 332.4 300.0 250.0 200.0 150.0 100.0 50.0 0.0 104.5 124.8 51.7 23.8 3.8 2011 47.2 42.3 4.9 2012 2013 2014 2015 Syphilis Gonorrhoea Chlamydia (pre-CTAD) Genital Herpes Genital Warts Chlamydia (CTAD) Any increase in gonorrhoea diagnoses may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in MSM. Any decrease in genital wart diagnoses may be due to a moderately protective effect of HPV-16/18 vaccination. Any increase in genital herpes diagnoses may be due to the use of more sensitive NAATs. Increases or decreases may also reflect changes in testing practices. Due to changes in 2012 to the surveillance of chlamydia, comparisons to previous years are not robust. Source: Public Health England, GUMCAD (level 3 services), CTAD, NCSP and laboratory chlamydia data. 5 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data Table 1: Percentage change in New STI diagnoses. East Midlands residents Diagnoses New STIs Syphilis Gonorrhoea Chlamydia Genital Herpes Genital Warts 2015 29,334 229 1,960 15,415 2,191 4,846 % change 2011-2015 2014-2015 -7% 34% 47% 82% -1% -10% -7% -8% -14% -2% Please see notes for Figure 3. Due to changes in 2012 to the surveillance of chlamydia diagnosed outside GUM, comparisons for chlamydia and for New STIs before and after 2012 are not robust and, therefore, have not been presented. Source: Public Health England, GUMCAD (level 3 services), CTAD, NCSP and laboratory chlamydia data. . 6 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data Figure 4: Rate of New STIs per 100,000 residents by age group in the East Midlands, 2015 Age group (years) 45-64 Male Female 35-44 25-34 20-24 15-19 4000.0 3000.0 2000.0 1000.0 0.0 1000.0 2000.0 3000.0 4000.0 5000.0 Rate per 100,000 population Source: Public Health England, GUMCAD (level 3 services) and CTAD. 7 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data Figure 5: Rates by ethnicity per 100,000 population of East Midlands residents diagnosed with a New STI, 2015 Rate per 100,000 population 2,500.0 2,000.0 1,500.0 1,000.0 500.0 489.8 2,102.9 1,410.2 528.1 White Black Caribbean Black African Other BME 0.0 Source: Public Health England, GUMCAD (level 3 services) and CTAD. 8 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data Table 2: Proportion of East Midlands residents diagnosed with a New STI by ethnicity, 2015 Ethnic group White Black Caribbean Black African Other BME Unknown Number 19,818 608 589 2,198 6,121 Percentage excluding unknown 85% 3% 3% 9% Source: Public Health England, GUMCAD (level 3 services) and CTAD. 9 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data Figure 6: Diagnoses of the five main STIs among men who have sex with men (MSM) in GUM clinics: East Midlands residents, 2011 to 2015 700 605 Number of diagnoses 600 500 400 300 200 100 342 245 176 117 133 160 87 44 58 0 2011 Syphilis 2012 Gonorrhoea 2013 Chlamydia 2014 Genital Herpes 2015 Genital Warts GUMCAD started in 2009. Reporting of sexual orientation is less likely to be complete for earlier years, so rises seen may be partly artefactual. Any increase in gonorrhoea diagnoses may be due to the increased use of highly sensitive nucleic acid amplification tests (NAATs) and additional screening of extra-genital sites in MSM. Any decrease in genital wart diagnoses may be due to a moderately protective effect of HPV-16/18 vaccination. Any increase in genital herpes diagnoses may be due to the use of more sensitive NAATs. Any increase or decrease may reflect changes in testing. Source: Public Health England, GUMCAD (level 3 services). 10 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data Table 3: Percentage change in New STI diagnoses in men who have sex with men (MSM) diagnosed in GUM clinics. East Midlands residents Diagnoses New STIs Syphilis Gonorrhoea Chlamydia Genital Herpes Genital Warts Please see notes for Figure 6. 2015 1,613 133 605 342 58 160 % change 2011-2015 2014-2015 73% 53% 244% 40% 32% 37% Source: Public Health England, GUMCAD (level 3 services). 11 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data 10% 45% 9% -5% 35% 38% Figure 7a: Rate of New STI diagnoses per 100,000 population among East Midlands residents by local authority of residence, 2015 1,400.0 PHEC rate (632.6) England rate (767.6) 1,000.0 800.0 600.0 0.0 Source: Public Health England, GUMCAD (level 3 services) and CTAD. 12 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data 376 482 490 558 573 683 704 200.0 881 400.0 1,245 Rate per 100,000 population 1,200.0 Figure 7b: Rate of New STI diagnoses (excluding chlamydia diagnoses in persons aged 15 to 24 years) per 100,000 population aged 15 to 64 years among East Midlands residents by local authority of residence, 2015 1,200.0 PHEC rate (602) England rate (814.9) Rate per 100,000 population 1,000.0 800.0 600.0 400.0 0.0 Source: Public Health England, GUMCAD (level 3 services) and CTAD. 13 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data 390 441 478 508 593 697 710 713 1,040 200.0 PHE recommends that local areas should be working towards achieving a chlamydia detection rate of at least 2,300 per 100,000 among individuals aged 15 to 24 years. 2,500.0 2,000.0 1,500.0 1,000.0 0.0 Source: Public Health England, GUMCAD (level 3 services) and CTAD. 14 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data 1,087 1,540 1,541 1,653 1,820 1,889 2,010 2,162 500.0 2,191 Rate per 100,000 population aged 15-24 years Figure 8: Chlamydia detection rate per 100,000 population aged 15 to 24 years in the East Midlands by upper tier local authority of residence, 2015 Figure 9: Rate of gonorrhoea diagnoses per 100,000 population in the East Midlands by upper tier local authority of residence, 2015 160.0 120.0 100.0 80.0 11 60.0 0.0 Source: Public Health England, GUMCAD (level 3 services). 15 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data 21 21 28 45 46 57 20.0 62 40.0 128 Rate per 100,000 population 140.0 Figure 10: Map of New STI rates per 100,000 residents by upper tier local authority in the East Midlands, 2015 Source: Public Health England, GUMCAD (level 3 services) and CTAD 16 Annual Epidemiological Spotlight on STIs in the East Midlands: 2015 data