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Trends in the epidemiology of bacterial sexually transmitted infections in eastern Europe, 1995–2005
  1. A Uusküla1,
  2. A Puur2,
  3. K Toompere1,
  4. J DeHovitz3
  1. 1Department of Public Health, University of Tartu, Tartu, Estonia
  2. 2Estonian Interuniversity Population Research Center, Tallinn University, Tallinn, Estonia
  3. 3Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
  1. Correspondence to Dr Anneli Uusküla, Department of Public Health, University of Tartu, Ravila 19, Tartu 50411, Estonia; anneli.uuskula{at}


Background Sexually transmitted infections (STI) are a significant public health problem both worldwide and in Europe. This article reviews trends in the epidemiology of the major bacterial STI in eastern European countries, their key determinants, as well as challenges and opportunities for enhancing STI control in the region.

Search strategy Publications were sought through computerised searches in PubMed from 1995 to 2008 using using free text and relevant medical subject headings with no language restrictions. Conference abstracts and other unpublished manuscripts were excluded.

Results The reported rates of STI in many eastern European countries have either decreased (syphilis and gonorrhoea in the eastern/Russian regions, gonorrhoea throughout eastern Europe) or been relatively stable (syphilis in the southeastern region, chlamydia throughout eastern Europe), in the past decade, but are still significantly higher than in western Europe. There is a significant east–west geopolitical gradient in reported STI rates throughout eastern Europe (STI rates: Russia/eastern region>>southeastern region>central region). Challenges for STI control include: the need to strengthen public health components of control; improvements in surveillance and improvement, as well as quality assurance, in diagnostic strategies. Gains in STI control may be achieved through greater collaboration and harmonisation of practicss at the European level.

  • Chlamydia trachomatis
  • eastern Europe
  • epidemiology
  • gonorrhoea
  • sexually transmitted infection
  • syphilis

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  • Supplementary web appendix is published online only at

  • Funding This study was finances by the National Institutes of Health, Norwegian Financial Mechanism/EEA (grant EE0016), the Estonian Ministry of Education and Science (target funded project 0132703s05) and Estonian Science Foundation (grant 7619).

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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