Estimating prevalence trends in adult gonorrhoea and syphilis in low- and middle-income countries with the Spectrum-STI model

Results for Zimbabwe and Morocco from 1995 to 2016

Eline L. Korenromp, Guy Mahiané, Jane Rowley, Nico Nagelkerke, Laith Aburaddad, Francis Ndowa, Amina El-Kettani, Houssine El-Rhilani, Philippe Mayaud, R. Matthew Chico, Carel Pretorius, Kendall Hecht, Teodora Wi

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective To develop a tool for estimating national trends in adult prevalence of sexually transmitted infections by low- and middle-income countries, using standardised, routinely collected programme indicator data. Methods The Spectrum-STI model fits time trends in the prevalence of active syphilis through logistic regression on prevalence data from antenatal clinic-based surveys, routine antenatal screening and general population surveys where available, weighting data by their national coverage and representativeness. Gonorrhoea prevalence was fitted as a moving average on population surveys (from the country, neighbouring countries and historic regional estimates), with trends informed additionally by urethral discharge case reports, where these were considered to have reasonably stable completeness. Prevalence data were adjusted for diagnostic test performance, high-risk populations not sampled, urban/rural and male/female prevalence ratios, using WHO's assumptions from latest global and regional-level estimations. Uncertainty intervals were obtained by bootstrap resampling. Results Estimated syphilis prevalence (in men and women) declined from 1.9% (95% CI 1.1% to 3.4%) in 2000 to 1.5% (1.3% to 1.8%) in 2016 in Zimbabwe, and from 1.5% (0.76% to 1.9%) to 0.55% (0.30% to 0.93%) in Morocco. At these time points, gonorrhoea estimates for women aged 15-49 years were 2.5% (95% CI 1.1% to 4.6%) and 3.8% (1.8% to 6.7%) in Zimbabwe; and 0.6% (0.3% to 1.1%) and 0.36% (0.1% to 1.0%) in Morocco, with male gonorrhoea prevalences 14% lower than female prevalence. Conclusions This epidemiological framework facilitates data review, validation and strategic analysis, prioritisation of data collection needs and surveillance strengthening by national experts. We estimated ongoing syphilis declines in both Zimbabwe and Morocco. For gonorrhoea, time trends were less certain, lacking recent population-based surveys.

Original languageEnglish
Pages (from-to)599-606
Number of pages8
JournalSexually Transmitted Infections
Volume93
Issue number8
DOIs
Publication statusPublished - 1 Dec 2017

Fingerprint

Zimbabwe
Morocco
Gonorrhea
Syphilis
Sexually Transmitted Diseases
Population
Prenatal Diagnosis
Routine Diagnostic Tests
Uncertainty
Logistic Models
Surveys and Questionnaires

Keywords

  • Africa
  • Gonorrhoea
  • mathematical model
  • surveillance
  • syphilis

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

Cite this

Estimating prevalence trends in adult gonorrhoea and syphilis in low- and middle-income countries with the Spectrum-STI model : Results for Zimbabwe and Morocco from 1995 to 2016. / Korenromp, Eline L.; Mahiané, Guy; Rowley, Jane; Nagelkerke, Nico; Aburaddad, Laith; Ndowa, Francis; El-Kettani, Amina; El-Rhilani, Houssine; Mayaud, Philippe; Chico, R. Matthew; Pretorius, Carel; Hecht, Kendall; Wi, Teodora.

In: Sexually Transmitted Infections, Vol. 93, No. 8, 01.12.2017, p. 599-606.

Research output: Contribution to journalArticle

Korenromp, EL, Mahiané, G, Rowley, J, Nagelkerke, N, Aburaddad, L, Ndowa, F, El-Kettani, A, El-Rhilani, H, Mayaud, P, Chico, RM, Pretorius, C, Hecht, K & Wi, T 2017, 'Estimating prevalence trends in adult gonorrhoea and syphilis in low- and middle-income countries with the Spectrum-STI model: Results for Zimbabwe and Morocco from 1995 to 2016', Sexually Transmitted Infections, vol. 93, no. 8, pp. 599-606. https://doi.org/10.1136/sextrans-2016-052953
Korenromp, Eline L. ; Mahiané, Guy ; Rowley, Jane ; Nagelkerke, Nico ; Aburaddad, Laith ; Ndowa, Francis ; El-Kettani, Amina ; El-Rhilani, Houssine ; Mayaud, Philippe ; Chico, R. Matthew ; Pretorius, Carel ; Hecht, Kendall ; Wi, Teodora. / Estimating prevalence trends in adult gonorrhoea and syphilis in low- and middle-income countries with the Spectrum-STI model : Results for Zimbabwe and Morocco from 1995 to 2016. In: Sexually Transmitted Infections. 2017 ; Vol. 93, No. 8. pp. 599-606.
@article{18faf31445e04223a753e7fa089bdda6,
title = "Estimating prevalence trends in adult gonorrhoea and syphilis in low- and middle-income countries with the Spectrum-STI model: Results for Zimbabwe and Morocco from 1995 to 2016",
abstract = "Objective To develop a tool for estimating national trends in adult prevalence of sexually transmitted infections by low- and middle-income countries, using standardised, routinely collected programme indicator data. Methods The Spectrum-STI model fits time trends in the prevalence of active syphilis through logistic regression on prevalence data from antenatal clinic-based surveys, routine antenatal screening and general population surveys where available, weighting data by their national coverage and representativeness. Gonorrhoea prevalence was fitted as a moving average on population surveys (from the country, neighbouring countries and historic regional estimates), with trends informed additionally by urethral discharge case reports, where these were considered to have reasonably stable completeness. Prevalence data were adjusted for diagnostic test performance, high-risk populations not sampled, urban/rural and male/female prevalence ratios, using WHO's assumptions from latest global and regional-level estimations. Uncertainty intervals were obtained by bootstrap resampling. Results Estimated syphilis prevalence (in men and women) declined from 1.9{\%} (95{\%} CI 1.1{\%} to 3.4{\%}) in 2000 to 1.5{\%} (1.3{\%} to 1.8{\%}) in 2016 in Zimbabwe, and from 1.5{\%} (0.76{\%} to 1.9{\%}) to 0.55{\%} (0.30{\%} to 0.93{\%}) in Morocco. At these time points, gonorrhoea estimates for women aged 15-49 years were 2.5{\%} (95{\%} CI 1.1{\%} to 4.6{\%}) and 3.8{\%} (1.8{\%} to 6.7{\%}) in Zimbabwe; and 0.6{\%} (0.3{\%} to 1.1{\%}) and 0.36{\%} (0.1{\%} to 1.0{\%}) in Morocco, with male gonorrhoea prevalences 14{\%} lower than female prevalence. Conclusions This epidemiological framework facilitates data review, validation and strategic analysis, prioritisation of data collection needs and surveillance strengthening by national experts. We estimated ongoing syphilis declines in both Zimbabwe and Morocco. For gonorrhoea, time trends were less certain, lacking recent population-based surveys.",
keywords = "Africa, Gonorrhoea, mathematical model, surveillance, syphilis",
author = "Korenromp, {Eline L.} and Guy Mahian{\'e} and Jane Rowley and Nico Nagelkerke and Laith Aburaddad and Francis Ndowa and Amina El-Kettani and Houssine El-Rhilani and Philippe Mayaud and Chico, {R. Matthew} and Carel Pretorius and Kendall Hecht and Teodora Wi",
year = "2017",
month = "12",
day = "1",
doi = "10.1136/sextrans-2016-052953",
language = "English",
volume = "93",
pages = "599--606",
journal = "Sexually Transmitted Infections",
issn = "1368-4973",
publisher = "BMJ Publishing Group",
number = "8",

}

TY - JOUR

T1 - Estimating prevalence trends in adult gonorrhoea and syphilis in low- and middle-income countries with the Spectrum-STI model

T2 - Results for Zimbabwe and Morocco from 1995 to 2016

AU - Korenromp, Eline L.

AU - Mahiané, Guy

AU - Rowley, Jane

AU - Nagelkerke, Nico

AU - Aburaddad, Laith

AU - Ndowa, Francis

AU - El-Kettani, Amina

AU - El-Rhilani, Houssine

AU - Mayaud, Philippe

AU - Chico, R. Matthew

AU - Pretorius, Carel

AU - Hecht, Kendall

AU - Wi, Teodora

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Objective To develop a tool for estimating national trends in adult prevalence of sexually transmitted infections by low- and middle-income countries, using standardised, routinely collected programme indicator data. Methods The Spectrum-STI model fits time trends in the prevalence of active syphilis through logistic regression on prevalence data from antenatal clinic-based surveys, routine antenatal screening and general population surveys where available, weighting data by their national coverage and representativeness. Gonorrhoea prevalence was fitted as a moving average on population surveys (from the country, neighbouring countries and historic regional estimates), with trends informed additionally by urethral discharge case reports, where these were considered to have reasonably stable completeness. Prevalence data were adjusted for diagnostic test performance, high-risk populations not sampled, urban/rural and male/female prevalence ratios, using WHO's assumptions from latest global and regional-level estimations. Uncertainty intervals were obtained by bootstrap resampling. Results Estimated syphilis prevalence (in men and women) declined from 1.9% (95% CI 1.1% to 3.4%) in 2000 to 1.5% (1.3% to 1.8%) in 2016 in Zimbabwe, and from 1.5% (0.76% to 1.9%) to 0.55% (0.30% to 0.93%) in Morocco. At these time points, gonorrhoea estimates for women aged 15-49 years were 2.5% (95% CI 1.1% to 4.6%) and 3.8% (1.8% to 6.7%) in Zimbabwe; and 0.6% (0.3% to 1.1%) and 0.36% (0.1% to 1.0%) in Morocco, with male gonorrhoea prevalences 14% lower than female prevalence. Conclusions This epidemiological framework facilitates data review, validation and strategic analysis, prioritisation of data collection needs and surveillance strengthening by national experts. We estimated ongoing syphilis declines in both Zimbabwe and Morocco. For gonorrhoea, time trends were less certain, lacking recent population-based surveys.

AB - Objective To develop a tool for estimating national trends in adult prevalence of sexually transmitted infections by low- and middle-income countries, using standardised, routinely collected programme indicator data. Methods The Spectrum-STI model fits time trends in the prevalence of active syphilis through logistic regression on prevalence data from antenatal clinic-based surveys, routine antenatal screening and general population surveys where available, weighting data by their national coverage and representativeness. Gonorrhoea prevalence was fitted as a moving average on population surveys (from the country, neighbouring countries and historic regional estimates), with trends informed additionally by urethral discharge case reports, where these were considered to have reasonably stable completeness. Prevalence data were adjusted for diagnostic test performance, high-risk populations not sampled, urban/rural and male/female prevalence ratios, using WHO's assumptions from latest global and regional-level estimations. Uncertainty intervals were obtained by bootstrap resampling. Results Estimated syphilis prevalence (in men and women) declined from 1.9% (95% CI 1.1% to 3.4%) in 2000 to 1.5% (1.3% to 1.8%) in 2016 in Zimbabwe, and from 1.5% (0.76% to 1.9%) to 0.55% (0.30% to 0.93%) in Morocco. At these time points, gonorrhoea estimates for women aged 15-49 years were 2.5% (95% CI 1.1% to 4.6%) and 3.8% (1.8% to 6.7%) in Zimbabwe; and 0.6% (0.3% to 1.1%) and 0.36% (0.1% to 1.0%) in Morocco, with male gonorrhoea prevalences 14% lower than female prevalence. Conclusions This epidemiological framework facilitates data review, validation and strategic analysis, prioritisation of data collection needs and surveillance strengthening by national experts. We estimated ongoing syphilis declines in both Zimbabwe and Morocco. For gonorrhoea, time trends were less certain, lacking recent population-based surveys.

KW - Africa

KW - Gonorrhoea

KW - mathematical model

KW - surveillance

KW - syphilis

UR - http://www.scopus.com/inward/record.url?scp=85021838017&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021838017&partnerID=8YFLogxK

U2 - 10.1136/sextrans-2016-052953

DO - 10.1136/sextrans-2016-052953

M3 - Article

VL - 93

SP - 599

EP - 606

JO - Sexually Transmitted Infections

JF - Sexually Transmitted Infections

SN - 1368-4973

IS - 8

ER -