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S15 STI epidemiology in Europe: challenges for prevention and control
S15.1 Sexually transmitted infections in Europe: coordinating the European STI network
  1. M van de Laar
  1. European Centre for Disease Prevention and Control, Stockholm, Sweden


Background Since 2008, the European Centre for Disease Prevention and Control is coordinating the enhanced STI surveillance in 30 EU/EEA countries. Each country was requested to nominate experts for collaboration and data submission to the European Surveillance System. Five STI are under surveillance, syphilis, congenital syphilis, gonorrhoea, chlamydia and LGV, as per Decision 2119/98/EC of the European Commission.

Methods Surveillance objectives and the set of variables for enhanced STI surveillance were agreed upon in the annual network meeting and training session to use the European Surveillance System for data submission. Data were collected for the period 1990–2009; two network meetings were organised for all 30 EU/EEA countries to discuss the preliminary results.

Results Chlamydia is the most frequently reported STI in Europe, accounting for the majority of all STI reports with 343 958 cases in 2009 (185 per 100 000 population). Chlamydia was reported more in women than in men and 75% were reported in young people (15 and 24 years). Chlamydia is increasing continuously over time. In 2009, 29 202 gonorrhoea cases have been reported (9.7/100 000) and nearly a quarter of all gonorrhoea cases were reported in MSM. For syphilis, 18 317 cases have been reported (4.5 per 100 000) and half of syphilis cases were reported in MSM. The overall trend in gonorrhoea and syphilis across the EU/EEA showed a notable decreasing trend in countries which previously had reported very high rates. These declines are probably due to changes in healthcare systems, diagnostic capacity and reporting rather than true changes in the incidence. However, dramatic increases were noted in other countries and—based on the information from the male-to-female ratio—this is most likely due to recent increases of syphilis among MSM. The overall trend in chlamydia showed a continuously increasing trend, reflecting an increase in testing and screening practices across countries. These trends must be interpreted with caution due to the heterogeneity in reporting and healthcare systems. A further limitation to the interpretation is that many diagnoses are either not made or under-reported. Diagnoses from certain countries cannot be included in trend analyses as they do not have comprehensive surveillance for STI.

Conclusion Enhanced surveillance of STI in Europe is essential to provide the information that is necessary to monitor the distribution of disease and to evaluate the public health response to control the transmission of infections. Collaborating within the European STI expert networks provides the platform for sharing best practices and expert knowledge across Europe.

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