Document Detail


Recent declines in reported syphilis rates in eastern Europe and central Asia: are the epidemics over?
MedLine Citation:
PMID:  11141852     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Since the early 1990s, major syphilis epidemics have occurred in the Newly Independent States (NIS) of the former Soviet Union. The new and rapidly changing societal and economic conditions in these countries challenge their traditional approaches to the control of sexually transmitted infections (STI). Nevertheless, following a steady increase until 1997, reported syphilis incidence has declined during the past 3 years in most parts of the region. We examine these trends against a background of ongoing changes in service delivery, care seeking behaviour, and case finding practices. METHODS: National syphilis surveillance data reported to the WHO Regional Office for Europe were compiled and analysed, and supplemented with information presented at recent expert meetings and with results from ongoing research. RESULTS: Since 1997, reported syphilis incidence either stabilised or declined in many locations in the NIS, but further increased in others, especially in rural areas. Congenital syphilis continued to increase in all countries, except Latvia. The proportion of self presenting cases versus cases detected through screening declined, and so did notifications of early compared with late forms of syphilis. Patients increasingly seek care in the private formal and informal healthcare sectors which hardly participate in case reporting. CONCLUSIONS: Recent declines in syphilis notifications in the NIS are at least partially a reflection of a reduced intensity of active case finding and of changes in reporting completeness because of a shift in service utilisation from the public to the private/informal sectors. Syphilis rates are still high, indicating that both public and private sectors have to respond more efficiently to the needs of many people at risk of STI. The collection of serial STI prevalence data is recommended to be able to validate trends in notifications.
Authors:
G Riedner; K L Dehne; A Gromyko
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Sexually transmitted infections     Volume:  76     ISSN:  1368-4973     ISO Abbreviation:  Sex Transm Infect     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2001-01-04     Completed Date:  2001-02-08     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9805554     Medline TA:  Sex Transm Infect     Country:  England    
Other Details:
Languages:  eng     Pagination:  363-5     Citation Subset:  IM    
Affiliation:
WHO Regional Office for Europe, Copenhagen, Denmark. Gabriele.Riedner@lshtm.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Asia, Central / epidemiology
Contact Tracing / trends
Delivery of Health Care / trends
Disease Notification / statistics & numerical data
Endemic Diseases / statistics & numerical data*
Europe, Eastern / epidemiology
Female
Humans
Incidence
Infant, Newborn
Male
Patient Acceptance of Health Care
Pregnancy
Private Sector
Syphilis / epidemiology*
Syphilis, Congenital / epidemiology
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