Trends in the epidemiology of bacterial sexually transmitted infections in eastern Europe, 1995-2005.
BACKGROUND
Sexually transmitted infections (STI) are a significant public health problem both worldwide and in Europe. This article reviews trends in the epidemiology of the major bacterial STI in eastern European countries, their key determinants, as well as challenges and opportunities for enhancing STI control in the region.


METHODS
Publications were sought through computerised searches in PubMed from 1995 to 2008 using using free text and relevant medical subject headings with no language restrictions. Conference abstracts and other unpublished manuscripts were excluded.


RESULTS
The reported rates of STI in many eastern European countries have either decreased (syphilis and gonorrhoea in the eastern/Russian regions, gonorrhoea throughout eastern Europe) or been relatively stable (syphilis in the southeastern region, chlamydia throughout eastern Europe), in the past decade, but are still significantly higher than in western Europe. There is a significant east-west geopolitical gradient in reported STI rates throughout eastern Europe (STI rates: Russia/eastern region>>southeastern region>central region). Challenges for STI control include: the need to strengthen public health components of control; improvements in surveillance and improvement, as well as quality assurance, in diagnostic strategies. Gains in STI control may be achieved through greater collaboration and harmonisation of practicss at the European level.
Uusküla
A
A
Department of Public Health, University of Tartu, Ravila 19, Tartu 50411, Estonia. anneli.uuskula@ut.ee
Puur
A
A
Toompere
K
K
DeHovitz
J
J
D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D005544:Forecasting; D006801:Humans; D015994:Incidence; D008297:Male; D011159:Population Surveillance / Q000379:methods; D015231:Sexually Transmitted Diseases, Bacterial / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D012922:Social Change; D012959:Socioeconomic Factors