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Sentinel surveillance of sexually transmitted infections in South Africa: a review
  1. L F Johnson1,
  2. D J Coetzee2,
  3. R E Dorrington1
  1. 1Centre for Actuarial Research, University of Cape Town, South Africa
  2. 2School of Public Health and Family Medicine, University of Cape Town, South Africa
  1. Correspondence to:
 Leigh Johnson
 Centre for Actuarial Research, 10 University Avenue, University of Cape Town, Private Bag, Rondebosch 7701, South Africa;


Objectives: To review studies of sexually transmitted infection (STI) prevalence in South Africa between 1985 and 2003 in selected sentinel populations. To examine how STI prevalence varies between populations and to identify the limitations of the existing data.

Methods: Studies of the prevalence of syphilis, chancroid, granuloma inguinale, lymphogranuloma venereum, gonorrhoea, chlamydia, trichomoniasis, bacterial vaginosis, candidiasis, and herpes simplex virus type 2 (HSV-2) were considered. Results were included if they related to women attending antenatal clinics or family planning clinics, commercial sex workers, individuals in the general population (household surveys), patients with STIs, patients with genital ulcer disease (GUD), or men with urethritis.

Results: High STI prevalence rates have been measured, particularly in the case of HSV-2, trichomoniasis, bacterial vaginosis and candidiasis. The aetiological profile of GUD appears to be changing, with more GUD caused by HSV-2 and less caused by chancroid. The prevalence of gonorrhoea and syphilis is highest in “high risk” groups such as sex workers and attenders of STI clinics, but chlamydia and trichomoniasis prevalence levels are not significantly higher in these groups than in women attending antenatal clinics.

Conclusions: The prevalence of STIs in South Africa is high, although there is extensive variability between regions. There is a need for STI prevalence data that are more nationally representative and that can be used to monitor prevalence trends more reliably.

  • GUD, genital ulcer disease
  • ELISA, enzyme linked immunosorbent assay
  • HSV, herpes simplex virus
  • RPR, rapid plasma reagin
  • STI, sexually transmitted infection
  • STIs
  • South Africa
  • sentinel surveillance

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  • Competing interests: none.