Abstract

ObjectiveTo generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15–49 years, in 2016.MethodsFor chlamydia, gonorrhoea and trichomoniasis, we systematically searched for studies conducted between 2009 and 2016 reporting prevalence. We also consulted regional experts. To generate estimates, we used Bayesian meta-analysis. For syphilis, we aggregated the national estimates generated by using Spectrum-STI.FindingsFor chlamydia, gonorrhoea and/or trichomoniasis, 130 studies were eligible. For syphilis, the Spectrum-STI database contained 978 data points for the same period. The 2016 global prevalence estimates in women were: chlamydia 3.8% (95% uncertainty interval, UI: 3.3–4.5); gonorrhoea 0.9% (95% UI: 0.7–1.1); trichomoniasis 5.3% (95% UI:4.0–7.2); and syphilis 0.5% (95% UI: 0.4–0.6). In men prevalence estimates were: chlamydia 2.7% (95% UI: 1.9–3.7); gonorrhoea 0.7% (95% UI: 0.5–1.1); trichomoniasis 0.6% (95% UI: 0.4–0.9); and syphilis 0.5% (95% UI: 0.4–0.6). Total estimated incident cases were 376.4 million: 127.2 million (95% UI: 95.1–165.9 million) chlamydia cases; 86.9 million (95% UI: 58.6–123.4 million) gonorrhoea cases; 156.0 million (95% UI: 103.4–231.2 million) trichomoniasis cases; and 6.3 million (95% UI: 5.5–7.1 million) syphilis cases.ConclusionGlobal estimates of prevalence and incidence of these four curable sexually transmitted infections remain high. The study highlights the need to expand data collection efforts at country level and provides an initial baseline for monitoring progress of the World Health Organization global health sector strategy on sexually transmitted infections 2016–2021.

Highlights

  • Transmitted infections are among the most common communicable conditions and affect the health and lives of people worldwide

  • Chlamydia and gonorrhoea can cause serious short- and long-term complications, including pelvic inflammatory disease, ectopic pregnancy, infertility, chronic pelvic pain and arthritis, and they can be transmitted during pregnancy or delivery

  • All four infections are implicated in increasing the risk of human immunodeficiency virus (HIV) acquisition and transmission.[7]

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Summary

Introduction

Transmitted infections are among the most common communicable conditions and affect the health and lives of people worldwide. The World Health Organization (WHO) periodically generates estimates to gauge the global burden of four of the most common curable sexually transmitted infections: chlamydia (etiological agent: Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae), trichomoniasis (Trichomonas vaginalis) and syphilis (Treponema pallidum).[1,2,3,4,5,6] The estimates provide evidence for programme improvement, monitoring and evaluation. These sexually transmitted infections cause acute urogenital conditions such as cervicitis, urethritis, vaginitis and genital ulceration, and some of the etiological agents infect the rectum and pharynx. People with sexually transmitted infections often experience stigma, stereotyping, vulnerability, shame and gender-based violence.[8]

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