SYDNEY, Australia — Sexually transmitted diseases have spread so widely in some Aboriginal communities that mass treatment without individual testing, even for children as young as 10, is the only way to fight the problem, according to a medical paper published Monday.
The authors of the paper, Dr. Frank Bowden and Dr. Katherine Fethers, contend that the traditional method of screening and treating people individually is not working because patients often move on before their test results have been returned and because of a lack of resources.
Their paper, in The Medical Journal of Australia, recommends that when more than 10 percent of the population has sexually transmitted diseases, “all individuals within a particular age range would be offered antibiotic treatment without recourse to an individual risk assessment and without waiting for the results of diagnostic testing.”
Because there is widespread evidence of sexually transmitted diseases in children in these communities, Dr. Bowden suggested that everyone age 10 and older be offered the treatment, with adults giving informed consent.
A 2005 survey of indigenous communities in the Northern Territory showed that more than one in four residents had either chlamydia or gonorrhea.
Dr. Bowden noted that treatment of whole communities is common for other infectious diseases, like trachoma, which can cause blindness. Chlamydia, which can cause infertility and pelvic inflammation if untreated, is caused by the same bacterium as trachoma.
“The major difference is the way we frame the two conditions,” the paper said. “One is seen as a disease of poverty; the other is seen to be related to personal and deeply private behavior.”
Dr. Bowden has compared rates of infection in nonindigenous communities, where gonorrhea and chlamydia are relatively rare, with those in indigenous communities, where he describes the problem as hyperendemic.