RESUMO
Objectives@#To estimate prevalence levels of and time trends for active syphilis, gonorrhoea and chlamydia in women aged 15–49 years in four countries in the Pacific (Fiji, the Federated States of Micronesia [FSM], Papua New Guinea [PNG] and Samoa) to inform surveillance and control strategies for sexually transmitted infections (STIs).@*Methods@#The Spectrum-STI model was fitted to data from prevalence surveys and screenings of adult female populations collected during 1995−2017 and adjusted for diagnostic test performance and to account for undersampled high-risk populations. For chlamydia and gonorrhoea, data were further adjusted for age and differences between urban and rural areas.@*Results@#Prevalence levels were estimated as a percentage (95% confidence interval). In 2017, active syphilis prevalence was estimated in Fiji at 3.89% (2.82 to 5.06), in FSM at 1.48% (0.93 to 2.16), in PNG at 3.91% (1.67 to 7.24) and in Samoa at 0.16% (0.07 to 0.37). For gonorrhoea, the prevalence in Fiji was 1.63% (0.50 to 3.87); in FSM it was 1.59% (0.49 to 3.58); in PNG it was 11.0% (7.25 to 16.1); and in Samoa it was 1.61% (1.17 to 2.19). The prevalence of chlamydia in Fiji was 24.1% (16.5 to 32.7); in FSM it was 23.9% (18.5 to 30.6); in PNG it was 14.8% (7.39 to 24.7); and in Samoa it was 30.6% (26.8 to 35.0). For each specific disease within each country, the 95% confidence intervals overlapped for 2000 and 2017, although in PNG the 2017 estimates for all three STIs were below the 2000 estimates. These patterns were robust in the sen sitivity analyses.@*Discussion@#This study demonstrated a persistently high prevalence of three major bacterial STIs across four countries in WHO’s Western Pacific Region during nearly two decades. Further strengthening of strategies to control and prevent STIs is warranted.
RESUMO
Monthly flea and small mammal surveys covering three seasons (cool dry, hot dry and monsoon) were carried out at three townships in Yangon. From more than 400 small ammmals captured, two species of fleas totalling about 700 were collected and identified as Xenopsylla astia and Xenopsylla cheopis. General flea inded was found to be highest in May (dry hot) with 6.7 and lowest in November (cool dry) with 0.09. Total ratio of collected X. astia and X. cheopis was foung to be about 2:1. However, host-vector specificity was pronounced between these two species especially on B. bengalensis. The great majority of X. astia were infested on B. bengalensis (p < 0.05) and the majority of X. cheopis were infested on other above ground species namely Rattus exulans, R. rattus and Suncus murinus mainly in dry hot seasons. Several factors which might govern the host-vector specificity are outlined. Dur to the host-vector specificity, the limitations and the use of various flea indices are discussed and suggestions are made for a proper surveillance system. The prospect of the timely flela control program as a preventive plague control measure is also discussed.