SEXUALLY-TRANSMITTED DISEASE SYNDROMES IN RURAL SOUTH-AFRICA - RESULTS FROM HEALTH FACILITY SURVEILLANCE

Background and Objective: Surveillance for sexually transmitted diseas es (STD) is important for priority setting, service development, and e valuating interventions. Goal: To conduct health facility-based survei llance for STDs to inform design of a control program and to provide b aseline measures for evaluation of interventions. Study Design: Survei llance system for patients with STD syndromes in public and private se ctor health facilities in Hlabisa, South Africa. Results: Over a 5-mon th period, 4,781 patients with an STD mere reported, 3,126 (65%) by cl inics and 1,655 (35%) by general practitioners; 2,582 (54%) were in me n, Most were diagnosed with a single syndrome. Discharge was most comm on (49% of both male and female patients), followed by ulcer (36% of m en and 14% of women). Mean symptom duration was 18 days for women and 10 days for men (p < 0.0001). A quarter reported having another STD in the previous 3 months. The highest age-specific incidence was estimat ed at 16.4% among women 20 to 24 years of age. Conclusions: The burden of STDs Is high in rural South Africa. There is considerable scope fo r improved disease control, and the private sector has an important ro le to play.