{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:02:19Z","timestamp":1785175339013,"version":"3.55.0"},"reference-count":34,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Fred Hollows Foundation using UK Aid"},{"DOI":"10.13039\/501100004324","name":"Sightsavers International","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004324","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,6,22]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sexually transmitted infections (STIs) are a major public health problem globally, particularly in low and middle-income countries. In the Western Pacific region, including Nauru, STIs are highly prevalent. Syndromic management misses a high proportion of infections and screen-and-treat strategies are not currently feasible at scale in these settings. Mass drug administration (MDA), widely used for control of neglected tropical diseases, may provide an alternative approach to the population control of STIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We used a before-and-after study design to evaluate the impact of azithromycin MDA for trachoma control on STI prevalence in Nauru. The study enrolled 381 participants aged 18\u201329 years before MDA and 360 participants 6 months after MDA, with similar age distribution but a higher proportion of women post-MDA. Urine specimens were tested for\n                      <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                      ,\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      ,\n                      <jats:italic>Mycoplasma genitalium<\/jats:italic>\n                      and\n                      <jats:italic>Trichomonas vaginalis<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      At baseline,\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      infection was present in 21.7% of participants followed by\n                      <jats:italic>T. vaginalis<\/jats:italic>\n                      and\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      (21.2% and 10.9%, respectively), while\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      was detected in 2.7% of participants. At 6 months after azithromycin MDA, prevalence declined for all STIs except\n                      <jats:italic>T. vaginalis<\/jats:italic>\n                      . Relative reductions were 35% (95% CI 9.7 to 52.8) for\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      , 67% (\u221215.2 to 91.1) for\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      and 47% (10.7 to 68.2) for\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      . Reductions in prevalence following MDA were greater in men than women but CIs overlapped.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>This study provides the first evaluation among both men and women of changes in STI prevalence following azithromycin MDA in a high-prevalence general population. The potential role of this strategy in STI control needs further exploration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056858","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T17:20:23Z","timestamp":1785172823000},"page":"sextrans-2025-056858","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Sexually transmitted infection prevalence following azithromycin mass drug administration for trachoma in Nauru: a before-and-after cross-sectional survey"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9038-5300","authenticated-orcid":false,"given":"Lucia","family":"Romani","sequence":"first","affiliation":[{"name":"Kirby Institute, UNSW Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue Chen","family":"Apadinuwe","sequence":"additional","affiliation":[{"name":"Ministry of Health and Medical Services, Denig, Nauru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisling","family":"Byrne","sequence":"additional","affiliation":[{"name":"Kirby Institute, UNSW Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine C","family":"Marshall","sequence":"additional","affiliation":[{"name":"Kirby Institute, UNSW Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Starr","sequence":"additional","affiliation":[{"name":"St Vincent's Centre for Applied Medical Research, St Vincent\u2019s Hospital, NSW State Reference Laboratory for HIV, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen D","family":"Lynch","sequence":"additional","affiliation":[{"name":"University of Queensland, UQ Centre for Clinical Research, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8279-7652","authenticated-orcid":false,"given":"Handan","family":"Wand","sequence":"additional","affiliation":[{"name":"Kirby Institute, UNSW Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Star","sequence":"additional","affiliation":[{"name":"Ministry of Health and Medical Services, Denig, Nauru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Cunningham","sequence":"additional","affiliation":[{"name":"St Vincent's Centre for Applied Medical Research, St Vincent\u2019s Hospital, NSW State Reference Laboratory for HIV, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2709-193X","authenticated-orcid":false,"given":"Stephen B","family":"Lambert","sequence":"additional","affiliation":[{"name":"University of Queensland, UQ Centre for Clinical Research, Brisbane, Queensland, Australia"},{"name":"National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kaldor","sequence":"additional","affiliation":[{"name":"Kirby Institute, UNSW Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana Vaz","family":"Nery","sequence":"additional","affiliation":[{"name":"Kirby Institute, UNSW Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026072710201825000_sextrans-2025-056858v1.1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.18.228486"},{"key":"2026072710201825000_sextrans-2025-056858v1.2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz145"},{"key":"2026072710201825000_sextrans-2025-056858v1.3","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318175d885"},{"key":"2026072710201825000_sextrans-2025-056858v1.4","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1071\/SH15227","article-title":"Prevalence and risk factors of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and other sexually transmissible infections among women attending antenatal clinics in three provinces in Papua New Guinea: a cross-sectional survey","volume":"13","author":"Vallely","year":"2016","journal-title":"Sex Health"},{"key":"2026072710201825000_sextrans-2025-056858v1.5","unstructured":"Romani L , Fong J , Dashika B . 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