Elsevier

The Lancet

Volume 351, Supplement 3, June 1998, Pages S2-S4
The Lancet

Supplement
Global epidemiology of sexually transmitted diseases

https://doi.org/10.1016/S0140-6736(98)90001-0Get rights and content

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Incidence and prevalence of STDs

The two main sources of information on the prevalence and incidence of a particular disease are case-notification reports and epidemiological studies. In countries with good reporting systems, the number of reported cases is a good proxy for the total number of infections if the disease has very definite symptoms. STDs, however, are often symptomless and when there are symptoms they are often not specific. For example, estimates indicate that 70–75% of women infected with Chlamydia trachomatis

Disease burden

In the 1993 World Development Report,9 1990 estimates suggested that, in demographically developing countries, STDs excluding HIV accounted for 8·9% of the disease burden in women aged 15–45 years and 1·5% in men in the same age class. This ranked STDs, excluding HIV, as the second major cause of lost disability-adjusted life years in women of reproductive age.

The vast majority of the disease burden from STDs is a result of the complications and sequelae that may follow infection. For example,

STD prevention and care

The control of STDs is a public-health priority and one that has become of even higher priority with the HIV epidemic. Since STDs and HIV share many behavioural risk factors, efforts to encourage individuals to modify sexual behaviours and adopt safer sexual practices will have a beneficial impact on both. In addition, data from a number of studies strongly suggest that both ulcerative and non-ulcerative STDs facilitate HIV transmission.11 As a result, a community-based, randomised trial has

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