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Description of the network

The European Network for STI Surveillance comprises the contact points for STI surveillance that are nominated by the competent bodies for surveillance in EU/EFTA, and contains both epidemiological and microbiological experts.

This section describes the network's epidemiological and microbiological activities.

Epidemiology

Diseases under surveillance at the EU level include chlamydia infection (including lymphogranuloma venereum), gonorrhoea and syphilis (including congenital syphilis).

General objectives for surveillance of sexually transmitted infections, including HIV/AIDS, are:

  • Monitor trends in STI and HIV/AIDS over time in order to assess the present situation and to compare trends across Member States in Europe to respond to rises above warning thresholds and to facilitate appropriate evidence-based action;
  • Detect and monitor any multi-state outbreaks of STI and HIV/AIDS with respect to source, time, person, population and place in order to provide a rationale for public health action;
  • Identify population groups at risk and in need for targeted prevention measures;
  • Contribute to the evaluation and monitoring of prevention and control programmes targeted at STI and HIV/AIDS to provide the evidence for recommendations to strengthen and improve these programmes at the national and European level (long-term  objective);
  • Develop behavioural surveillance for HIV and STI related to sexual activity and drug use and develop behavioural indicators to be used at the EU level (long-term objective)

Disease-specific objectives

Chlamydia specific surveillance objectives:

  • Monitor testing rates for chlamydia, preferably by age and gender, across Member States to be able to interpret the available surveillance data for chlamydia;
  • Estimate the prevalence of chlamydia infection with respect to age and gender in Europe (feasibility study; long-term research objective)

Gonorrhoea specific surveillance objectives:

  • Detect and monitor the resistance patterns in gonococci, preferably by epidemiological characteristics, in Europe to contribute to the treatment guidelines of gonorrhoea;
  • Ensure appropriate treatment by promoting the coordination of laboratory network on gonococci resistance testing, including QA and training

Syphilis specific surveillance objectives:

  • Monitor the occurrence of congenital syphilis in the Member States by epidemiological characteristics;
  • Generate hypotheses for risk factors across Europe (feasibility study)

Microbiology

Background

Reliable, accurate and comparable laboratory data for STI is essential to underpin profound and useful surveillance data at the EU level, as well as being central to effective patient management.

As antibiotic resistance in Neisseria gonorrhoeae becomes an increasing problem globally, sentinel surveillance to monitor antimicrobial resistance in Neisseria gonorrhoeae is essential. In particular to detect the emergence of resistance to the currently recommended third generation cephalosporins, as there is a lack of alternative treatments. Molecular typing may also play a critical role in preserving therapeutic options by providing a means of understanding dissemination of such resistant strains.

The network for STI Microbiology surveillance comprises the laboratory contact points nominated by the competent bodies for surveillance in EU/EFTA Member States. The  terms of reference comprises of the following objectives:

  • To improve the quality of laboratory surveillance of gonorrhoea, syphilis, congenital syphilis and infection with chlamydia trachomatis (including LGV) in EU/EFTA Member States;
  • To strengthen the surveillance of Neisseria gonorrhoeae susceptibility in EU/EFTA Member States, including an EQA scheme;
  • To perform molecular typing of resistant Neisseria gonorrhoeae strains; develop a proposal on how to contribute to timely detection of STI clusters by performing molecular surveillance;
  • To contribute to and take part in the Network for STI surveillance in EU/EFTA Member States

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