Components of STI Surveillance Systems – in detail

Components of STI Surveillance Systems – in detail

Universal STI Reporting

Types of

reports used

In universal reporting, minimal data elements about STIs are collected from all health facilities in the country. The minimum data include information such as STI syndrome or aetiology by age group and gender.

disadvantages

The advantages and disadvantages of universal reporting for STIs are outlined in Table 6.5

Table 6.5. Advantages and disadvantages of universal STI reporting.

Discussing

the table

Look at Table 6.5 and answer the following questions:

1. 
   Why does universal reporting provide poor assessment of disease burden among women?
   

2. 
   Does universal reporting provide a direct estimate of the population burden of STIs? Why or why not?
   

Prevalence Assessment and Monitoring

Definition

and terms

Here are some of the terms used in prevalence assessment and monitoring:

• 
  Prevalence of a disease or infection—the proportion of people in a population who have the disease or infection at a specified time.
  

• 
  Prevalence monitoring—following prevalence trends over time to see if they are increasing or decreasing.
  

• 
  STI prevalence assessment and monitoring—using surveys to determine what percentage or how many people have STIs when compared to the total population.
  

• 
  part of a combined STI/HIV behavioural survey
  
• 
  part of a national HIV sero-prevalence survey
  
• 
  a standalone project.
  

The STIs that can be included in surveys are:

• 
  syphilis
  
• 
  gonorrhoea
  
• 
  chlamydia
  
• 
  Herpes simplex virus
  
• 
  hepatitis B
  

assessment and

monitoring

The main purposes of STI prevalence assessment and monitoring are to:

• 
  identify population sub-groups with high prevalence of STIs
  
• 
  monitor trends in STI prevalence among defined populations.
  

Prevalence assessments are used in various situations:

• 
  In prevalence assessment and monitoring, interventions (such as screening and treatment) are part of the surveillance activity.
  
• 
  Prevalence assessment may also be performed as part of a study. These studies are designed to obtain data for programme planning.
  
• 
  Often, STI prevalence is monitored in routinely screened, defined populations. For example, women are routinely screened for syphilis during antenatal care or delivery. The main purpose of screening at antenatal clinics is detection and treatment of STIs. Determination of prevalence is not the main goal.
  

Programme

planning

STI prevalence data are of great use in HIV and STI programme planning, management and evaluation. They are used to:

• 
  develop national estimates of STIs
  
• 
  identify population sub-groups at high risk for HIV infection (as evidenced by high rates of STIs)
  
• 
  guide funding and resource allocation for STI and HIV prevention programmes
  
• 
  monitor effectiveness of STIs and HIV prevention programmes
  
• 
  intervene in the transmission of STIs through screening and treatment.
  

Prevalence trends may be altered by changes in the population being screened for several reasons:

• 
  different types of clinics; for example, an STI clinic may get different results than a clinic serving the general population
  
• 
  change in the population's health-seeking behaviour
  
• 
  change in criteria used to select persons for screening
  
• 
  change in diagnostic tests, especially for chlamydia, which often vary in sensitivity and specificity.
  

Any changes should be recorded and taken into account in the interpretation of trend data.