Sexually transmitted infections in the non-European Union and European Economic Area of the World Health Organization European Region 2021-2023.

BACKGROUND

Sexually transmitted infections (STIs) continue to be a significant public health challenge and have an impact on sexual and reproductive health. European Union and European Economic Area (EU/EEA) countries report data annually on the number of cases of syphilis, gonorrhoea, chlamydia, and lymphogranuloma venereum (LGV) to the European Centre for Disease Prevention and Control. No similar system exists for the non-EU/EEA countries in the WHO European Region, and therefore, the sub-regional overview was unclear due to the limited data availability and inconsistency.

METHODS

We conducted a survey among 24 WHO member states in the WHO European Region that did not belong to the EU/EEA as of June 2024. The survey collected data on STI surveillance systems and numbers of reported cases of syphilis, gonorrhoea, chlamydia and LGV from 2021 to 2023.

RESULTS

Twenty-one completed the survey, of which 19 (79%) agreed to publish their data. All 19 countries reported surveillance activities for syphilis, 18 for gonorrhoea and chlamydia, and 8 for LGV. The comprehensiveness and coverage of surveillance systems varied between countries and infections. Total cases reported increased from 13,553 to 17,113 (notification rate per 100,000 population 5.4 to 6.9) for syphilis and 12,001 to 13,067 (4.2 to 5.0) for gonorrhoea between 2021 and 2023, while chlamydia cases decreased from 32,556 to 27,802 (13.3 to 11.2). Only one to two LGV cases were reported per year. Various challenges were identified in antimicrobial-resistant gonorrhoea surveillance.

CONCLUSIONS

In non-EU/EEA countries, STI cases are likely to be underreported due to incomplete surveillance systems and other factors. Given the increase in the number of reported cases of syphilis and gonorrhoea between 2021 and 2023 and the significant public health consequences of untreated STIs, an accelerated joint effort to strengthen the surveillance systems of the non-EU/EEA countries is warranted to move towards ending epidemics of STIs in the WHO European Region by 2030.