Sentinel surveillance of sexually transmitted infections in South Africa: a review.
OBJECTIVE
To review studies of sexually transmitted infection (STI) prevalence in South Africa between 1985 and 2003 in selected sentinel populations. To examine how STI prevalence varies between populations and to identify the limitations of the existing data.


METHODS
Studies of the prevalence of syphilis, chancroid, granuloma inguinale, lymphogranuloma venereum, gonorrhoea, chlamydia, trichomoniasis, bacterial vaginosis, candidiasis, and herpes simplex virus type 2 (HSV-2) were considered. Results were included if they related to women attending antenatal clinics or family planning clinics, commercial sex workers, individuals in the general population (household surveys), patients with STIs, patients with genital ulcer disease (GUD), or men with urethritis.


RESULTS
High STI prevalence rates have been measured, particularly in the case of HSV-2, trichomoniasis, bacterial vaginosis and candidiasis. The aetiological profile of GUD appears to be changing, with more GUD caused by HSV-2 and less caused by chancroid. The prevalence of gonorrhoea and syphilis is highest in "high risk" groups such as sex workers and attenders of STI clinics, but chlamydia and trichomoniasis prevalence levels are not significantly higher in these groups than in women attending antenatal clinics.


CONCLUSIONS
The prevalence of STIs in South Africa is high, although there is extensive variability between regions. There is a need for STI prevalence data that are more nationally representative and that can be used to monitor prevalence trends more reliably.
Johnson
L F
LF
Centre for Actuarial Research, 10 University Avenue, University of Cape Town, Private Bag, Rondebosch 7701, South Africa. ljohnson@commerce.uct.ac.za
Coetzee
D J
DJ
Dorrington
R E
RE
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012423:Rural Health; D018571:Sentinel Surveillance; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013019:South Africa / Q000453:epidemiology; D014504:Urban Health