Epidemiology of syphilis, gonorrhoea and chlamydia in the Centre and East part of the WHO European Region

In their article published in Eurosurveillance, Bozicevic et al. analysed data on reported cases of syphilis, gonorrhoea and chlamydia for the period 2015 to 2019 from 18 non-EU/EEA countries of the World Health Organization’s European Region. During this time, the number of reported cases per 100,000 population was 0.4–26.5 for syphilis, 0–18.5 for gonorrhoea and 0–43.3 for chlamydia.

In contrast to the countries of the European Union and European Economic Area (EU/EEA), in most of the non-EU/EEA countries of the Region with three or more data points in the period 2015 to 2019 there seem to be decreasing trends in reported cases of syphilis, gonorrhoea and chlamydia.

Among the reporting countries, Georgia observed the highest syphilis case rate in the last included year (2018 or 2019 depending on data availability) with 26.5 cases per 100,000 population, followed by Kazakhstan (18.8/100,000) and the Russian Federation (16.6/100,000). In comparison, EU/EEA countries had a crude notification rate of syphilis of 7.0 per 100,000 population in 2018. The highest rates were recorded in Malta (17.9/100,000), Luxembourg (17.1/100,000) and the United Kingdom (12.6/100,000).

Higher proportion of men with syphilis and gonorrhoea
Georgia also had the highest rate of reported chlamydia and gonorrhoea cases in the last included year (2018 or 2019) with 52.0 per 100,000 chlamydia cases and 18.5 per 100,000 respectively. Belarus had a chlamydia notification rate of 43.3 per 100,000 and the Ukraine of 31.6 per 100,000. Gonorrhoea rates were above 10 per 100,000 population in Kazakhstan and Uzbekistan with a pattern of decrease in the most recently reported rates in the countries that had available data for at least 3 years, with the exception of Azerbaijan.

While most of the countries reported more cases of syphilis and gonorrhoea in men than in women, chlamydia cases in women outnumbered those in men in the majority of countries.  

In the period from 2015 to 2018, only four non-EU/EEA countries reported antimicrobial resistance and susceptibility testing data of at least one drug to the Gonococcal Antimicrobial Surveillance Programme, namely Belarus, Kyrgyzstan, the Russian Federation and Ukraine.

The authors note a still rather limited availability of sexually transmitted infections (STI) data in the Centre and Eastern part of the WHO European Region, including AMR data in gonococci. This influences comparability with available STI data from EU/EEA. They advocate for improved availability and quality of STI surveillance data “so as to better estimate the burden of STI, measure progress towards the STI control targets set by the WHO and guide the implementation of national STI control programmes.”
 

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References/notes to editors:
[1] Barbaric Jelena, Kuchukhidze Giorgi, Seguy Nicole, Vovc Elena, Babovic Maria Josefina Theresa, Wi Teodora Elvira, Low-Beer Daniel, Bozicevic Ivana. Surveillance and epidemiology of syphilis, gonorrhoea and chlamydia in the non-European Union countries of the World Health Organization European Region, 2015 to 2020. Euro Surveill. 2022;27(8):pii=2100197.
Available from: www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.8.2100197

[2] Epidemiological data on STI are available for 30 European Union (EU)/European Economic Area (EEA) countries that participate in the European STI Surveillance Network and report through the European Surveillance System (TESSy). However, information is scarce from the non-EU/EEA countries of the WHO European Region.

[3] Without adequate treatment, sexually transmitted infections (STI) may have serious long-term health consequences, such as reproductive health complications and increased risk of acquiring HIV or cancers. STI surveillance is essential for the development of STI programmes, advocacy and management of cases. Core components of STI surveillance include case reporting, STI prevalence surveys in populations at higher (e.g. female sex workers or men who have sex with men) and at lower risk (e.g. pregnant women and young people), assessment of STI syndrome aetiologies and assessment of antimicrobial resistance patterns.
Interpretation of STI data is influenced by their completeness and representativeness and by the laboratory methods used in STI diagnostics.

[4] Overview of countries of the WHO European Region available from: https://www.euro.who.int/en/countries