Genital warts trends in Australian and overseas-born people in Australia: A cross-sectional trend analysis to measure progress towards control and elimination

Background: Substantial declines in genital warts have been observed in countries with quadrivalent/nonavalent human papillomavirus (q/n HPV) vaccination programmes, with Australia showing the most pronounced and long-term reductions. No study has assessed progress towards elimination of genital war...

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Autores principales:	Laila Khawar, MPH, Hamish McManus, PhD, Tobias Vickers, MB BS, Eric P.F. Chow, PhD, Christopher K Fairley, PhD, Basil Donovan, MD, Dorothy A Machalek, PhD, David G Regan, PhD, Andrew E Grulich, PhD, Rebecca J Guy, PhD, Skye McGregor, PhD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Genital warts human papillomavirus HPV HPV vaccine human papillomavirus vaccination programmes HPV vaccination programmes Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/2af048fd5ecf4ae091bdb6b016da35eb
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spelling	oai:doaj.org-article:2af048fd5ecf4ae091bdb6b016da35eb2021-12-02T05:04:00ZGenital warts trends in Australian and overseas-born people in Australia: A cross-sectional trend analysis to measure progress towards control and elimination2666-606510.1016/j.lanwpc.2021.100251https://doaj.org/article/2af048fd5ecf4ae091bdb6b016da35eb2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666606521001607https://doaj.org/toc/2666-6065Background: Substantial declines in genital warts have been observed in countries with quadrivalent/nonavalent human papillomavirus (q/n HPV) vaccination programmes, with Australia showing the most pronounced and long-term reductions. No study has assessed progress towards elimination of genital warts in a nation-wide sample of patients, and migrants’ contribution to population-level control of genital warts. We assessed Australia's progress towards genital warts elimination by examining trends in diagnoses in Australian- and overseas-born patients of sexual health clinics (SHCs) across Australia.Methods: A cross-sectional trend analysis of new genital warts diagnoses among first-time patients of 34 SHCs, between 2004 and 2018, was performed. Rate ratios (RR) were calculated using Poisson regression models, for comparing trends in proportions of new genital warts diagnoses in Australian- and overseas-born patients during the pre-vaccination era (2004-2007) and the vaccination era (2008-2018), and by 2018 relative to 2004-2007.Findings: A total of 439,957 new patients (Australian-born: 230,230; overseas-born: 209,727) were seen at SHCs, 6•4% were diagnosed with genital warts (Australian-born: 7•1%; overseas-born: 5•6%). By 2018, there had been a 64% reduction in the proportion of all SHC patients with a genital warts diagnosis relative to 2004-2007 (RR: 0•36, 95% CI: 0•35-0•38). The decline was more pronounced at 72% (RR: 0•28, 95% CI: 0 •27-0•30) among Australian-born patients, with the greatest reduction in women and men aged <21 years, at 98% (RR: 0•02, 95% CI: 0•01-0•03) and 92% (RR: 0•08, 95% CI: 0•06-0•11), respectively. By 2018, there was a 49% reduction in the proportion of overseas-born patients diagnosed with genital warts (RR: 0•51, 95% CI:0•48-0•54), and a 21% reduction in overseas-born patients from countries with no or bivalent HPV (bHPV) vaccination programme (RR: 0•79, 95% CI: 0•71-0•90).Interpretation: The substantial reductions in Australian-born people is a testament to the efficacy of quadrivalent (qHPV) and nonavalent (nHPV) vaccines and the high and wide-spread vaccination coverage in Australia. However, population-wide elimination of genital warts in Australia is dependent on other countries initiating or expanding their own HPV vaccination programmes.Funding: The Australian Government Department of Health and Seqirus Australia.Laila Khawar, MPHHamish McManus, PhDTobias Vickers, MB BSEric P.F. Chow, PhDChristopher K Fairley, PhDBasil Donovan, MDDorothy A Machalek, PhDDavid G Regan, PhDAndrew E Grulich, PhDRebecca J Guy, PhDSkye McGregor, PhDElsevierarticleGenital wartshuman papillomavirusHPVHPV vaccinehuman papillomavirus vaccination programmesHPV vaccination programmesPublic aspects of medicineRA1-1270ENThe Lancet Regional Health. Western Pacific, Vol 16, Iss , Pp 100251- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Genital warts human papillomavirus HPV HPV vaccine human papillomavirus vaccination programmes HPV vaccination programmes Public aspects of medicine RA1-1270
spellingShingle	Genital warts human papillomavirus HPV HPV vaccine human papillomavirus vaccination programmes HPV vaccination programmes Public aspects of medicine RA1-1270 Laila Khawar, MPH Hamish McManus, PhD Tobias Vickers, MB BS Eric P.F. Chow, PhD Christopher K Fairley, PhD Basil Donovan, MD Dorothy A Machalek, PhD David G Regan, PhD Andrew E Grulich, PhD Rebecca J Guy, PhD Skye McGregor, PhD Genital warts trends in Australian and overseas-born people in Australia: A cross-sectional trend analysis to measure progress towards control and elimination
description	Background: Substantial declines in genital warts have been observed in countries with quadrivalent/nonavalent human papillomavirus (q/n HPV) vaccination programmes, with Australia showing the most pronounced and long-term reductions. No study has assessed progress towards elimination of genital warts in a nation-wide sample of patients, and migrants’ contribution to population-level control of genital warts. We assessed Australia's progress towards genital warts elimination by examining trends in diagnoses in Australian- and overseas-born patients of sexual health clinics (SHCs) across Australia.Methods: A cross-sectional trend analysis of new genital warts diagnoses among first-time patients of 34 SHCs, between 2004 and 2018, was performed. Rate ratios (RR) were calculated using Poisson regression models, for comparing trends in proportions of new genital warts diagnoses in Australian- and overseas-born patients during the pre-vaccination era (2004-2007) and the vaccination era (2008-2018), and by 2018 relative to 2004-2007.Findings: A total of 439,957 new patients (Australian-born: 230,230; overseas-born: 209,727) were seen at SHCs, 6•4% were diagnosed with genital warts (Australian-born: 7•1%; overseas-born: 5•6%). By 2018, there had been a 64% reduction in the proportion of all SHC patients with a genital warts diagnosis relative to 2004-2007 (RR: 0•36, 95% CI: 0•35-0•38). The decline was more pronounced at 72% (RR: 0•28, 95% CI: 0 •27-0•30) among Australian-born patients, with the greatest reduction in women and men aged <21 years, at 98% (RR: 0•02, 95% CI: 0•01-0•03) and 92% (RR: 0•08, 95% CI: 0•06-0•11), respectively. By 2018, there was a 49% reduction in the proportion of overseas-born patients diagnosed with genital warts (RR: 0•51, 95% CI:0•48-0•54), and a 21% reduction in overseas-born patients from countries with no or bivalent HPV (bHPV) vaccination programme (RR: 0•79, 95% CI: 0•71-0•90).Interpretation: The substantial reductions in Australian-born people is a testament to the efficacy of quadrivalent (qHPV) and nonavalent (nHPV) vaccines and the high and wide-spread vaccination coverage in Australia. However, population-wide elimination of genital warts in Australia is dependent on other countries initiating or expanding their own HPV vaccination programmes.Funding: The Australian Government Department of Health and Seqirus Australia.
format	article
author	Laila Khawar, MPH Hamish McManus, PhD Tobias Vickers, MB BS Eric P.F. Chow, PhD Christopher K Fairley, PhD Basil Donovan, MD Dorothy A Machalek, PhD David G Regan, PhD Andrew E Grulich, PhD Rebecca J Guy, PhD Skye McGregor, PhD
author_facet	Laila Khawar, MPH Hamish McManus, PhD Tobias Vickers, MB BS Eric P.F. Chow, PhD Christopher K Fairley, PhD Basil Donovan, MD Dorothy A Machalek, PhD David G Regan, PhD Andrew E Grulich, PhD Rebecca J Guy, PhD Skye McGregor, PhD
author_sort	Laila Khawar, MPH
title	Genital warts trends in Australian and overseas-born people in Australia: A cross-sectional trend analysis to measure progress towards control and elimination
title_short	Genital warts trends in Australian and overseas-born people in Australia: A cross-sectional trend analysis to measure progress towards control and elimination
title_full	Genital warts trends in Australian and overseas-born people in Australia: A cross-sectional trend analysis to measure progress towards control and elimination
title_fullStr	Genital warts trends in Australian and overseas-born people in Australia: A cross-sectional trend analysis to measure progress towards control and elimination
title_full_unstemmed	Genital warts trends in Australian and overseas-born people in Australia: A cross-sectional trend analysis to measure progress towards control and elimination
title_sort	genital warts trends in australian and overseas-born people in australia: a cross-sectional trend analysis to measure progress towards control and elimination
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/2af048fd5ecf4ae091bdb6b016da35eb
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Genital warts trends in Australian and overseas-born people in Australia: A cross-sectional trend analysis to measure progress towards control and elimination

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