Adult gonorrhea, chlamydia and syphilis prevalence, incidence, treatment and syndromic case reporting in South Africa : estimates using the Spectrum-STI model, 1990-2017

Show simple item record Kularatne, Ranmini S. Niit, Ronelle Rowley, Jane Kufa-Chakezha, Tendesayi Peters, Remco P.H. Taylor, Melanie M. Johnson, Leigh F. Korenromp, Eline L. 2019-10-02T09:48:04Z 2019-10-02T09:48:04Z 2018-10-15
dc.description S1 File. Prevalence data and biomedical assumptions. Including: A Table. Syphilis prevalence data from surveys, studies and routine ANC-based program screening, used in the Spectrum-STI estimation of adult syphilis prevalence in South Africa With references: [7, 8, 19, 46, 50, 70–97]. B Table. Spectrum assumptions on proportion of episodes symptomatic, proportions of symptomatic episodes treated, episode durations for treated and untreated episodes, and the resulting treatment coverage-weighted average episode durations. With references: [10, 19, 38]. C Table. Gonorrhea and chlamydia prevalence data used, and adjustments for diagnostic test performance and missing high-risk populations, and for chlamydia for age, in the Spectrum- STI prevalence trend estimation for 15–49 year-old adults, South Africa. With references: [32, 46, 50, 51, 72, 77, 80, 81, 86, 91–93, 95, 98–116]. en_ZA
dc.description S2 File. Reported STI cases, and STI prevalences among women with Vaginal Discharge Syndrome, South Africa. en_ZA
dc.description.abstract OBJECTIVES : To estimate trends in prevalence and incidence of syphilis, gonorrhea and chlamydia in adult men and women in South Africa. METHODS : The Spectrum-STI tool estimated trends in prevalence and incidence of active syphilis, gonorrhea and chlamydia, fitting South African prevalence data. Results were used, alongside programmatic surveillance data, to estimate trends in incident gonorrhea cases resistant to first-line treatment, and the reporting gap of symptomatic male gonorrhea and chlamydia cases treated but not reported as cases of urethritis syndrome. RESULTS : In 2017 adult (15–49 years) the estimated female and male prevalences for syphilis were 0.50% (95% CI: 0.32–0.80%) and 0.97% (0.19–2.28%), for gonorrhea 6.6% (3.8–10.8%) and 3.5% (1.7–6.1%), and for chlamydia 14.7% (9.9–21%) and 6.0% (3.8–10.4%), respectively. Between 1990 and 2017 the estimated prevalence of syphilis declined steadily in women and men, probably in part reflecting improved treatment coverage. For gonorrhea and chlamydia, estimated prevalence and incidence showed no consistent time trend in either women or men. Despite growing annual numbers of gonorrhea cases − reflecting population growth − the estimated number of first line treatment-resistant gonorrhea cases did not increase between 2008 and 2017, owing to changes in first-line antimicrobial treatment regimens for gonorrhea in 2008 and 2014/5. Case reporting completeness among treated male urethritis syndrome episodes was estimated at 10–28% in 2017. CONCLUSION : South Africa continues to suffer a high STI burden. Improvements in access and quality of maternal, STI and HIV health care services likely contributed to the decline in syphilis prevalence. The lack of any decline in gonorrhea and chlamydia prevalence highlights the need to enhance STI services beyond clinic-based syndromic case management, to reinvigorate primary STI and HIV prevention and, especially for women, to screen for asymptomatic infections. en_ZA
dc.description.department Medical Microbiology en_ZA
dc.description.librarian am2019 en_ZA
dc.description.sponsorship The World Health Organization, Department of Reproductive Health and Research en_ZA
dc.description.uri en_ZA
dc.identifier.citation Kularatne RS, Niit R, Rowley J, Kufa- Chakezha T, Peters RPH, Taylor MM, et al. (2018) Adult gonorrhea, chlamydia and syphilis prevalence, incidence, treatment and syndromic case reporting in South Africa: Estimates using the Spectrum-STI model, 1990-2017. PLoS ONE 13 (10): e0205863. en_ZA
dc.identifier.issn 1932-6203 (online)
dc.identifier.other 10.1371/journal.pone.0205863
dc.language.iso en en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights The work is made available under the Creative Commons CC0. en_ZA
dc.subject Adult gonorrhea en_ZA
dc.subject Treatment en_ZA
dc.subject Men and women en_ZA
dc.subject South Africa (SA) en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject Sexually transmitted infection (STI) en_ZA
dc.title Adult gonorrhea, chlamydia and syphilis prevalence, incidence, treatment and syndromic case reporting in South Africa : estimates using the Spectrum-STI model, 1990-2017 en_ZA
dc.type Article en_ZA

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