Recent changes in the reporting of STIs in Japan during the COVID-19 pandemic

Abstract

ObjectivesThe COVID-19 pandemic has had variable effects on the rates of STIs reported across the globe. This study sought to assess how the number of STI reports changed during the pandemic in Japan.MethodsWe used national infectious disease surveillance data from the National Institute of Infectious Diseases (Tokyo, Japan) for the period between January 2013 and December 2021. We compared reported rates of chlamydia, gonorrhoea, condyloma acuminata and genital herpes, as well as total notifications for HIV/AIDS and syphilis during the pandemic versus previous years in Japan. We used a quasi-Poisson regression to determine whether any given week or month between January 2018 and December 2021 had a significant excess or deficit of STIs. Notification values above or below the 95% upper and lower prediction thresholds were considered as statistically significant. The start of the pandemic was defined as January 2020.ResultsChlamydia generally remained within predicted range during the pandemic period. Reporting of gonorrhoea was significantly higher than expected throughout early-to-mid 2021 but otherwise generally remained within predicted range prior to 2021. Condyloma, herpes and HIV/AIDS reporting were transiently significantly lower than expected throughout the pandemic period, but no significant periods of higher-than-expected reporting were detected. Syphilis showed widespread evidence of significantly lower-than-predicted reporting throughout 2020 but eventually reversed, showing significantly higher-than-predicted reporting in mid-to-late 2021.ConclusionsThe COVID-19 pandemic was associated with variable changes in the reporting of STIs in Japan. Higher-than-predicted reporting was more likely to be observed in the later phases of the pandemic. These changes may have been attributable to pandemic-related changes in sexual behaviour and decreased STI clinic attendance and testing, but further research on the long-term impact of the pandemic on STIs is necessary.

Changes in Health Care Access during the COVID-19 Pandemic: Estimates of National Japanese Data, June 2020–October 2021

“…Second, many (but not all) hospitals imposed limits on the number of outpatient appointments (or closed outpatient departments altogether) due to COVID-19-related staff shortages, and in an attempt to minimize viral exposure among outpatients and health care workers [ 31 ]. These findings are consistent with widespread reports of decreased routine clinic visits including those for routine vaccinations, cancer screenings, and STI testing [ 5 , 6 , 7 , 8 , 9 ].…”

“…The COVID-19 pandemic has placed undue strain on health care systems around the world [ 1 ], and hospitals have been forced to make difficult decisions regarding the number of patients that can be admitted, the length of patient stays, and the preparation of COVID-19-dedicated beds. During the highest intensity periods of COVID-19 transmission, elective surgeries were routinely cancelled and waiting times were increased in order to conserve beds [ 2 , 3 , 4 ], and routine clinic visits such as those for vaccination [ 5 ], cancer screenings [ 6 , 7 , 8 ], and sexually transmitted disease testing [ 9 ] were often foregone [ 10 ]. In fact, the fear of contracting COVID-19 dissuaded many from even presenting to health care establishments [ 11 , 12 ], leading to breaks in the continuity of patient care, decreased preventive medicine, and delayed diagnosis and management of otherwise treatable medical conditions [ 13 ].…”

Effect of COVID-19 pandemic restrictions on chlamydia and gonorrhoea notifications and testing in Queensland, Australia: an interrupted time series analysis

“…Norway, Denmark and Sweden observed a relatively quick rebound of detected chlamydia cases, while Norway and Sweden observed longer lasting decreases in reported gonorrhoea cases in 2020 24. Interestingly, increases in gonorrhoea detection were reported in both Japan and Finland in 2021 25 26. Our findings demonstrate the importance of continued disease surveillance during and post-public health emergencies to understand the local epidemiology of diseases.…”

The impact of the COVID-19 pandemic on other infections differs by their route of transmission: A retrospective, observational study in Japan

“…Another report showed that syphilis in Tokyo increased gradually in 2021 [ 12 ], which was consistent with the present result. Different trends have been reported for sexually transmitted diseases, depending on the disease [ 13 ]. Further investigation should be performed to determine whether the rates of sexually transmitted diseases have remained at their decreased levels after the pandemic.…”