(P89) Epidemiology of Neisseria gonorrhoeae in Australia, New Zealand, and the Pacific Islands: Systematic review, meta-analyses, and meta-regressions

Background: Neisseria gonorrhoeae (NG) infection is a public health concern. This study aimed to characterize the epidemiology of NG in Australia, New Zealand, and the Pacific Islands. The study is ongoing and interim results are reported below.

Methods: NG-related data were reviewed, reported, synthesized, and analyzed up to September 30, 2022 informed by Cochrane and PRISMA guidelines. Random-effects meta-analyses were conducted to calculate pooled mean prevalence. Meta-regressions were performed to examine factors associated with higher prevalence and to investigate sources of heterogeneity.

Results: A total of 71 publications were included yielding 223 overall stratified NG prevalence measures. Pooled mean prevalence of current urogenital infection was 1.9% (95% CI: 0.2-4.5%) among general populations, 4.6% (95% CI: 0.0-18.5%) among female sex workers, and 5.2% (95% CI: 2.4-9.1%) among sexually transmitted infection (STI) clinic attendees. Pooled mean prevalence of current anorectal infection was 2.3% (95% CI: 1.2-3.7%) among men who have sex with men (MSM), and 6.7% (95% CI: 4.4-9.3%) among STI clinic attendees. Pooled mean prevalence of current oropharyngeal infection was 1.3 % (95% CI: 0.1-3.92%) among MSM and 6.9% (95% CI: 4.9-9.3%) among STI clinic attendees. Prevalence of current urogenital infection decreased by 0.94-fold (95% CI: 0.90-0.98) per year. Prevalence of current anorectal infection increased by 1.1-fold (95% CI: 1.0-1.1) per year. Prevalence of current oropharyngeal infection increased by 1.1-fold (95% CI: 1.0-1.2) per year.

Conclusions: Prevalence of current urogenital infection appears to be decreasing in Australia, New Zealand, and the Pacific Islands, but is comparable to the global prevalence. However, prevalence of current anorectal and oropharyngeal infection appears to be increasing. These findings provide an understanding of the epidemiology of NG in this region and support the need for prevention, screening, and surveillance programs to manage this infection.