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Trends in Adult Chlamydia and Gonorrhea Prevalence, Incidence and Urethral Discharge Case Reporting in Morocco over 1995-2015-Estimates Using the Spectrum-Sexually Transmitted Infection Model.
Sex Transm Dis. 2017 09; 44(9):557-564.ST

Abstract

BACKGROUND

Evolving health priorities and resource constraints mean that countries require data on sexually transmitted infections (STI) trends to inform program planning and resource allocation.

METHODS

The Spectrum modeling tool estimated prevalence and incidence of gonorrhea and chlamydia in Morocco's 15- to 49-year-old population, based on prevalence surveys. Incident cases, broken down between symptomatic and asymptomatic, and treated versus untreated, were compared with urethral discharge (UD) case reports, to estimate reporting completeness among treated UD cases.

RESULTS

Gonorrhea prevalence was estimated at 0.37% (95% confidence interval [CI], 0.14-1.0%) in women and 0.32% (0.12-0.87%) in men in 2015; chlamydia prevalences were 3.8% (95% CI, 2.1-6.4%) and 3.0% (95% CI, 1.7-5.1%). Corresponding estimated numbers of new cases in women and men in 2015 were 79,598 (95% CI, 23,918-256,206) and 112,013 (95% CI, 28,700-307,433) for gonorrhea, and 291,908 (95% CI, 161,064-524,270) and 314,032 (95% CI, 186,076-559,133) for chlamydia. Gonorrhea and chlamydia prevalence had declined by an estimated 41% and 27%, respectively, over 1995 to 2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviors. Reporting completeness among treated UD cases was estimated at 46% to 77% in 2015. Reported UD cases corresponded to 13% of all estimated (symptomatic and asymptomatic) gonorrhea and chlamydia cases.

CONCLUSIONS

STI declines and improvements in treatment coverage are consistent with Morocco's introduction of syndromic management in 2000, scale-up of prevention, and declining human immunodeficiency virus incidence. While gonorrhea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations.

Authors+Show Affiliations

From the *Ministry of Health, Directorate of Epidemiology and Disease Control, Rabat, Morocco; †Avenir Health, Glastonbury, CT; ‡Weill Cornell Medical College-Qatar, Cornell University, Doha, Qatar; §London, UK; ¶Malawi-Liverpool Wellcome Trust, Blantyre, Malawi; ∥UNAIDS Morocco country office, Rabat, Morocco; **STIs Laboratory, Department of Bacteriology, National Institute of Hygiene, Rabat, Morocco; and ††Avenir Health, Geneva, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28806354

Citation

El-Kettani, Amina, et al. "Trends in Adult Chlamydia and Gonorrhea Prevalence, Incidence and Urethral Discharge Case Reporting in Morocco Over 1995-2015-Estimates Using the Spectrum-Sexually Transmitted Infection Model." Sexually Transmitted Diseases, vol. 44, no. 9, 2017, pp. 557-564.
El-Kettani A, Mahiané G, Bennani A, et al. Trends in Adult Chlamydia and Gonorrhea Prevalence, Incidence and Urethral Discharge Case Reporting in Morocco over 1995-2015-Estimates Using the Spectrum-Sexually Transmitted Infection Model. Sex Transm Dis. 2017;44(9):557-564.
El-Kettani, A., Mahiané, G., Bennani, A., Abu-Raddad, L., Smolak, A., Rowley, J., Nagelkerke, N., El-Rhilani, H., Alami, K., Hançali, A., & Korenromp, E. (2017). Trends in Adult Chlamydia and Gonorrhea Prevalence, Incidence and Urethral Discharge Case Reporting in Morocco over 1995-2015-Estimates Using the Spectrum-Sexually Transmitted Infection Model. Sexually Transmitted Diseases, 44(9), 557-564. https://doi.org/10.1097/OLQ.0000000000000647
El-Kettani A, et al. Trends in Adult Chlamydia and Gonorrhea Prevalence, Incidence and Urethral Discharge Case Reporting in Morocco Over 1995-2015-Estimates Using the Spectrum-Sexually Transmitted Infection Model. Sex Transm Dis. 2017;44(9):557-564. PubMed PMID: 28806354.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in Adult Chlamydia and Gonorrhea Prevalence, Incidence and Urethral Discharge Case Reporting in Morocco over 1995-2015-Estimates Using the Spectrum-Sexually Transmitted Infection Model. AU - El-Kettani,Amina, AU - Mahiané,Guy, AU - Bennani,Aziza, AU - Abu-Raddad,Laith, AU - Smolak,Alex, AU - Rowley,Jane, AU - Nagelkerke,Nico, AU - El-Rhilani,Houssine, AU - Alami,Kamal, AU - Hançali,Amina, AU - Korenromp,Eline, PY - 2017/8/15/entrez PY - 2017/8/15/pubmed PY - 2018/4/21/medline SP - 557 EP - 564 JF - Sexually transmitted diseases JO - Sex Transm Dis VL - 44 IS - 9 N2 - BACKGROUND: Evolving health priorities and resource constraints mean that countries require data on sexually transmitted infections (STI) trends to inform program planning and resource allocation. METHODS: The Spectrum modeling tool estimated prevalence and incidence of gonorrhea and chlamydia in Morocco's 15- to 49-year-old population, based on prevalence surveys. Incident cases, broken down between symptomatic and asymptomatic, and treated versus untreated, were compared with urethral discharge (UD) case reports, to estimate reporting completeness among treated UD cases. RESULTS: Gonorrhea prevalence was estimated at 0.37% (95% confidence interval [CI], 0.14-1.0%) in women and 0.32% (0.12-0.87%) in men in 2015; chlamydia prevalences were 3.8% (95% CI, 2.1-6.4%) and 3.0% (95% CI, 1.7-5.1%). Corresponding estimated numbers of new cases in women and men in 2015 were 79,598 (95% CI, 23,918-256,206) and 112,013 (95% CI, 28,700-307,433) for gonorrhea, and 291,908 (95% CI, 161,064-524,270) and 314,032 (95% CI, 186,076-559,133) for chlamydia. Gonorrhea and chlamydia prevalence had declined by an estimated 41% and 27%, respectively, over 1995 to 2015. Prevalence declines probably related to improved STI treatment coverage, and decreasing risk behaviors. Reporting completeness among treated UD cases was estimated at 46% to 77% in 2015. Reported UD cases corresponded to 13% of all estimated (symptomatic and asymptomatic) gonorrhea and chlamydia cases. CONCLUSIONS: STI declines and improvements in treatment coverage are consistent with Morocco's introduction of syndromic management in 2000, scale-up of prevention, and declining human immunodeficiency virus incidence. While gonorrhea is four-fold more common as cause of clinical UD cases than chlamydia, Morocco continues to suffer a large, untreated burden of chlamydia. Reliable monitoring of both STIs requires new periodic surveys and/or novel forms of affordable surveillance beyond high-risk populations. SN - 1537-4521 UR - https://www.unboundmedicine.com/medline/citation/28806354/Trends_in_Adult_Chlamydia_and_Gonorrhea_Prevalence_Incidence_and_Urethral_Discharge_Case_Reporting_in_Morocco_over_1995_2015_Estimates_Using_the_Spectrum_Sexually_Transmitted_Infection_Model_ L2 - http://dx.doi.org/10.1097/OLQ.0000000000000647 DB - PRIME DP - Unbound Medicine ER -