Surveillance of sexually transmitted infections in primary care
- I Simms1,
- A-K Hurtig1,
- P A Rogers2,
- G Hughes1,
- K A Fenton1
- 1PHLS, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK
- 2PHLS Statistics Unit
- Correspondence to: Ian Simms, PHLS, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK; isimms{at}phls.org.uk
What do we need to do?
Surveillance of sexually transmitted infections (STI) provides information for public health action, a relation that was highlighted by the “National Strategy for Sexual Health and HIV” published recently by the Department of Health (England).1 Systematically collected, timely, accurate, detailed, representative STI surveillance data are needed to estimate the population burden of disease; monitor effectiveness of STI prevention; evaluate healthcare access; and assess determinants of transmission (box 1).
Box 1 Key objectives of STI surveillance
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detect trends
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provide population estimates of prevalence/incidence of infection/disease
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identify risk factors associated with infection/disease
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allow assessment of intervention strategies
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provide information to inform clinical practice and public health action
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be of high sensitivity (good coverage of the target conditions)
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use consistent, accurate diagnostic methods
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be able to detect outbreaks
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be effective and efficient
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present and disseminate data in a timely and accessible manner
England has one of the world’s most comprehensive STI surveillance systems based on data from genitourinary medicine (GUM) clinics (the KC60 return) and laboratory reports. Data are widely disseminated and used in strategic health planning at national and local levels.1 A weakness in English surveillance is that it does not provide the information needed to interpret changes in STI epidemiology. This is not unusual as there are similar weaknesses in surveillance systems in other countries, such as Sweden.2 Both the KC60 and laboratory report systems are being redeveloped: patient based data collection is being introduced in GUM; enhanced surveillance programmes have been developed for syphilis and gonorrhoea; and the laboratory report system is being expanded. Although improvements in coverage, availability, quality, timeliness, and representativeness are anticipated, lack of data from primary care remains.3,4 Substantial reservoirs of predominantly asymptomatic STIs, such as Chlamydia trachomatis, genital herpes simplex virus infection (HSV), human …
