Surveillance of STD syndromes:: contributing to the STD programme in Cote d'Ivoire
Surveillance of STD syndromes:: contributing to the STD programme in Cote d'Ivoire
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DOI：
10.1093/heapol/15.4.441
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发表时间：
2000-12-01
影响因子：
3.2
通讯作者：
Coulibaly, IM
中科院分区：
文献类型：
--
作者：
La Ruche, G;Ladner, J;Coulibaly, IM
在科特迪瓦，对性传播疾病的管理是基于综合症的方法。1995年建立的国家卫生信息系统每月监测三种性传播疾病综合症的数据：生殖器溃疡、分泌物和疣。每个社区公共诊所都收集信息，然后在29个区、10个地区进行整理，最后集中起来。我们评估了这些信息的相关性及其对STD方案的有用性。对1995年和1996年15岁及以上成年人通报的病例数进行了男女比较。病例的绝对数量与评估性病在卫生保健服务中的相对份额的咨询次数有关，与估计性病年发病率的人口规模有关。在一九九五至一九九六年期间，男性呈报的性病个案数目维持稳定，分别为32 410宗及31 470宗，但女性的个案则由64 794宗增至87 622宗，增幅达35%。结果，男性的性病年发病率没有变化（8%），但女性的发病率从17%上升到23%。然而，在这两年期间，性病在所有就诊中的相对比例在男子中从4.7%下降到3.5%，而在妇女中保持稳定，约为7.0%。在这2年期间，男性和女性溃疡数量的比例约为1：1，并且没有因地区而异。相比之下，妇女报告的出院人数是其他人的2.7倍，各区的性别比例各不相同。我们认为阴道分泌物通常是生理性的，对STD监测没有指导意义。相反，两性溃疡和男性出院情况为性传播疾病方案提供了相关信息，例如，可用于估计公共卫生服务所需的性传播疾病药物数量和评估性传播疾病的流行趋势。
In Cote d'Ivoire, management of sexually transmitted diseases (STDs) is based on a syndromic approach. The National Health Information System (NHIS), set up in 1995, supervises data drawn monthly on three STD syndromes: genital ulcers, discharges and warts. Information is collected in each community-based public clinic, collated in the 29 districts, then in the 10 regions, and finally centralized. We assessed the relevance of this information and its usefulness for the STD programme. The number of cases notified in adults of 15 years and above was compared in men and women for the years 1995 and 1996. The absolute number of cases was related to the number of consultations to evaluate the relative share of STDs in health care services, and to the population size to estimate STD annual incidence. Between 1995 and 1996, the number of reported STD cases remained steady in men, 32 410 and 31 470 cases, respectively, but increased by 35% in women, from 64 794 to 87 622 cases. As a result, STD annual incidence was unchanging in men (8%), but increased in women from 17 to 23%. However, between these two years, the relative contribution of STDs to all consultations decreased from 4.7 to 3.5% in men, while remaining steady in women, at around 7.0%. In this 2-year period, the ratio of the numbers of ulcers in men and women was about 1:1, and did not vary by district. in contrast, discharges were reported 2.7 times more by women, with a differing sex ratio from district to district. We suggest that vaginal discharges are often physiological, and are poorly instructive for STD surveillance. In contrast, ulcers in both genders, and male discharges, provide relevant information for the STD programme, for example to estimate the volume of STD drugs needed for public health services and to assess the epidemiological trends of STDs.