title: Sexually transmitted disease syndromes in rural South Africa. Results from health facility surveillance.
abstract: OBJECTIVE
  Surveillance for sexually transmitted diseases (STD) is important for priority setting, service development, and evaluating interventions.
  
  
  OBJECTIVE
  To conduct health facility-based surveillance for STDs to inform design of a control program and to provide baseline measures for evaluation of interventions.
  
  
  METHODS
  Surveillance system for patients with STD syndromes in public and private sector health facilities in Hlabisa, South Africa.
  
  
  RESULTS
  Over a 5-month period, 4,781 patients with an STD were reported, 3,126 (65%) by clinics and 1,655 (35%) by general practitioners; 2,582 (54%) were in men. Most were diagnosed with a single syndrome. Discharge was most common (49% of both male and female patients), followed by ulcer (36% of men and 14% of women). Mean symptom duration was 18 days for women and 10 days for men (p < 0.0001). A quarter reported having another STD in the previous 3 months. The highest age-specific incidence was estimated at 16.4% among women 20 to 24 years of age.
  
  
  CONCLUSIONS
  The burden of STDs is high in rural South Africa. There is considerable scope for improved disease control, and the private sector has an important role to play.
authors.affiliation: Centre for Epidemiological Research in South Africa, Medical Research Council, Hlabisa, South Africa.
authors.forename: D
authors.initials: D
authors.lastname: Wilkinson
authors.forename: A M
authors.initials: AM
authors.lastname: Connolly
authors.forename: A
authors.initials: A
authors.lastname: Harrison
authors.forename: M
authors.initials: M
authors.lastname: Lurie
authors.forename: S S
authors.initials: SS
authors.lastname: Karim
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000628:therapy; D013019:South Africa / Q000453:epidemiology