Abstract
BackgroundSexually Transmitted Infections (STIs) are a public health problem, especially for reproductive-age women. The aim of this study was to determine the incidence and trend of STIs during 11 years in Tunisia (2007–17).MethodsWe conducted a descriptive study including all women with curable STIs (chlamydia, gonorrhea, syphilis and trichomoniasis) diagnosed with the syndromic approach in all basic health care centers of the Governorate of Monastir (Tunisia) from 2007 to 2017. Syndromes included, Pelvic Pain (PP), Vaginal Discharge (VD) and Genital Ulceration (GU).ResultsWe analyzed 40,388 episodes of curable STIs with a crude incidence rate and age standardized incidence rate of 1393 (95% Confidence Interval (CI); 1348–1438) / 100,000 Person Year (PY) and 1328 (95%CI; 1284–1372) /100,000 PY respectively. The incidence rate showed a positive trend over 11 years for all age groups and syndromes. VD was the most common syndrome with a crude incidence rate of 1170/100,000 PY. For all syndromes, women aged 20 to 39 were the most affected age group (p < 0.001).ConclusionIn conclusion, the incidence rate of STIs episodes among women diagnosed with the syndromic approach was high, consistent with the global evidence. Focusing on reviewing STIs surveillance system in low and middle-income countries could allow the achievement of the ending of STIs epidemics by 2030.
Highlights
Transmitted Infections (STIs) are a public health problem, especially for reproductive-age women
This approach according to the World Health Organization (WHO) guidelines obtains the highest marks in terms of development rigor with ongoing training every 2 years and is the surveillance system that can best represent the epidemiology of Sexually Transmitted Infections (STIs) in general population, they may result in an underestimated burden due to asymptomatic cases and have moderate specificity and sensitivity [8, 9]
During 11 years, 40,388 episodes of four female curable STIs were diagnosed by syndromic approach in Basic health centers (BHC) in Monastir governorate with a mean of 3671 episodes /year
Summary
Transmitted Infections (STIs) are a public health problem, especially for reproductive-age women. World Health Organization’s (WHO) 2012 and 2016 estimates of the Dhouib et al BMC Public Health (2021) 21:1625 middle-income countries (LMICs) have higher estimated burdens of STIs than high-income countries (HICs) [2]. In these countries, STIs diagnostic tests are largely unavailable, expensive and technically demanding on microbiological surveillance systems, so that, surveillance of clinical syndromes called. Syndromic approach is easier to establish in public health This approach according to the WHO guidelines obtains the highest marks in terms of development rigor with ongoing training every 2 years and is the surveillance system that can best represent the epidemiology of STIs in general population, they may result in an underestimated burden due to asymptomatic cases and have moderate specificity and sensitivity [8, 9]. Few studies have used clinical surveillance data to establish the trend and incidence of certain curable STIs in the general population [14, 15]
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