• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of bullwhoWHO Home PageBulletin Home PageBulletin Home PageAbout Bulletine-mail AlertSubmissions
Bull World Health Organ. 1990; 68(5): 639–654.
PMCID: PMC2393188

Epidemiology of sexually transmitted diseases: the global picture.

Abstract

Sexually transmitted diseases (STD) are now the commonest group of notifiable infectious diseases in most countries, particularly in the age group of 15 to 50 years and in infants. Their control is important considering the high incidence of acute infections, complications and sequelae, their socioeconomic impact, and their role in increasing transmission of the human immunodeficiency virus (HIV). The worldwide incidence of major bacterial and viral STD is estimated at over 125 million cases yearly. STD are hyperendemic in many developing countries. In industrialized countries, the bacterial STD (syphilis, gonorrhoea, chancroid) declined from the peak during the Second World War till up to the late fifties, then increased during the sixties and early seventies, and they have been decreasing again from the late seventies till the present. In the industrialized world, diseases due to Chlamydia trachomatis, genital herpes virus, human papillomaviruses and human immunodeficiency virus are now more important than the classical bacterial ones; both groups remain major health problems in most developing countries. Infection rates are similar in both women and men, but women and infants bear the major burden of complications and serious sequelae. Infertility and ectopic pregnancies are often a consequence of pelvic inflammatory disease, and are preventable. Sexually transmitted diseases in pregnant women can result in prematurity, stillbirth and neonatal infections. In many areas 1-5% of newborns are at risk of gonococcal ophthalmia neonatorum, a blinding disease; congenital syphilis causes up to 25% of perinatal mortality. Genital and anal cancers (especially cervical cancer) are associated with viral sexually transmitted diseases (genital human papillomavirus and herpes virus infections). Urethral stricture and infertility are frequent sequelae in men.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Syphilis--United States, 1983. MMWR Morb Mortal Wkly Rep. 1984 Aug 3;33(30):433–441. [PubMed]
  • Summary of notifiable diseases, United States, 1987. MMWR Morb Mortal Wkly Rep. 1988 Sep 16;36(54):1–59. [PubMed]
  • Continuing increase in infectious syphilis--United States. MMWR Morb Mortal Wkly Rep. 1988 Jan 29;37(3):35–38. [PubMed]
  • Coutinho RA, Schoonhoven FJ, van den Hoek JA, Emsbroek JA. Influence of special surveillance programmes and AIDS on declining incidence of syphilis in Amsterdam. Genitourin Med. 1987 Jun;63(3):210–213. [PMC free article] [PubMed]
  • Lee CT, Thirumoorthy T. Epidemiology of syphilis in Singapore over three decades (1955-1986). Ann Acad Med Singapore. 1987 Oct;16(4):622–626. [PubMed]
  • Watson PA. The use of screening tests for sexually transmitted diseases in a Third World community -- a feasibility study in Malawi. Eur J Sex Transm Dis. 1985 Feb;2(2):63–65. [PubMed]
  • Jama H, Hederstedt B, Osman S, Omar K, Isse A, Bygdeman S. Syphilis in women of reproductive age in Mogadishu, Somalia: serological survey. Genitourin Med. 1987 Oct;63(5):326–328. [PMC free article] [PubMed]
  • Ratnam AV, Din SN, Hira SK, Bhat GJ, Wacha DS, Rukmini A, Mulenga RC. Syphilis in pregnant women in Zambia. Br J Vener Dis. 1982 Dec;58(6):355–358. [PMC free article] [PubMed]
  • Piot P, Meheus A. Epidémiologie des maladies sexuellement transmissibles dans les pays en développement. Ann Soc Belg Med Trop. 1983 Jun;63(2):87–110. [PubMed]
  • D'Costa LJ, Plummer FA, Bowmer I, Fransen L, Piot P, Ronald AR, Nsanze H. Prostitutes are a major reservoir of sexually transmitted diseases in Nairobi, Kenya. Sex Transm Dis. 1985 Apr-Jun;12(2):64–67. [PubMed]
  • Reeves WC, Quiroz E. Prevalence of sexually transmitted diseases in high-risk women in the Republic of Panama. Sex Transm Dis. 1987 Apr-Jun;14(2):69–74. [PubMed]
  • Hudson CP, Hennis AJ, Kataaha P, Lloyd G, Moore AT, Sutehall GM, Whetstone R, Wreghitt T, Karpas A. Risk factors for the spread of AIDS in rural Africa: evidence from a comparative seroepidemiological survey of AIDS, hepatitis B and syphilis in southwestern Uganda. AIDS. 1988 Aug;2(4):255–260. [PubMed]
  • Ahmed SA, Sanyal RK, Ahmed MG. Prevalence of syphilis in South Sudan. J Commun Dis. 1985 Sep;17(3):251–251. [PubMed]
  • Leslie-Harwit M, Meheus A. Sexually transmitted disease in young people: the importance of health education. Sex Transm Dis. 1989 Jan-Mar;16(1):15–20. [PubMed]
  • Rice RJ, Aral SO, Blount JH, Zaidi AA. Gonorrhea in the United States 1975-1984: is the giant only sleeping? Sex Transm Dis. 1987 Apr-Jun;14(2):83–87. [PubMed]
  • Arya OP, Lawson JB. Sexually transmitted diseases in the tropics. Epidemiological, diagnostic, therapeutic, and control aspects. Trop Doct. 1977 Apr;7(2):51–56. [PubMed]
  • Meheus A, Ballard R, Dlamini M, Ursi JP, Van Dyck E, Piot P. Epidemiology and aetiology of urethritis in Swaziland. Int J Epidemiol. 1980 Sep;9(3):239–245. [PubMed]
  • Nasah BT, Nguematcha R, Eyong M, Godwin S. Gonorrhea, Trichomonas and Candida among gravid and nongravid women in cameroon. Int J Gynaecol Obstet. 1980 Jul-Aug;18(1):48–52. [PubMed]
  • Mabey DC, Lloyd-Evans NE, Conteh S, Forsey T. Sexually transmitted diseases among randomly selected attenders at an antenatal clinic in The Gambia. Br J Vener Dis. 1984 Oct;60(5):331–336. [PMC free article] [PubMed]
  • George WF. An approach to VD control based on a study in Kingston, Jamaica. Br J Vener Dis. 1974 Jun;50(3):222–227. [PMC free article] [PubMed]
  • Laga M, Plummer FA, Nzanze H, Namaara W, Brunham RC, Ndinya-Achola JO, Maitha G, Ronald AR, D'Costa LJ, Bhullar VB, et al. Epidemiology of ophthalmia neonatorum in Kenya. Lancet. 1986 Nov 15;2(8516):1145–1149. [PubMed]
  • Goh TH, Ngeow YF, Teoh SK. Screening for gonorrhea in a prenatal clinic in Southeast Asia. Sex Transm Dis. 1981 Apr-Jun;8(2):67–69. [PubMed]
  • Arya OP, Nsanzumuhire H, Taber SR. Clinical, cultural, and demographic aspects of gonorrhoea in a rural community in Uganda. Bull World Health Organ. 1973;49(6):587–595. [PMC free article] [PubMed]
  • Mason PR, Katzenstein DA, Chimbira TH, Mtimavalye L. Microbial flora of the lower genital tract of women in labour at Harare Maternity Hospital. The Puerperal Sepsis Study Group. Cent Afr J Med. 1989 Mar;35(3):337–344. [PubMed]
  • Mandara NA, Takulia S, Kanyawana J, Mhalu F. Asymptomatic gonorrhoea in women attending family planning clinics in Dar es Salaam, Tanzania. Results of a pilot study. Trop Geogr Med. 1980 Dec;32(4):329–332. [PubMed]
  • Hall SM, Whitcomb MA. Screening for gonorrhoea in family planning acceptors in a developing community. Public Health. 1978 May;92(3):121–124. [PubMed]
  • Chlamydia trachomatis infections. Policy guidelines for prevention and control. MMWR Morb Mortal Wkly Rep. 1985 Aug 23;34 (Suppl 3):53S–74S. [PubMed]
  • Magder LS, Harrison HR, Ehret JM, Anderson TS, Judson FN. Factors related to genital Chlamydia trachomatis and its diagnosis by culture in a sexually transmitted disease clinic. Am J Epidemiol. 1988 Aug;128(2):298–308. [PubMed]
  • Leclerc A, Frost E, Collet M, Goeman J, Bedjabaga L. Urogenital Chlamydia trachomatis in Gabon: an unrecognised epidemic. Genitourin Med. 1988 Oct;64(5):308–311. [PMC free article] [PubMed]
  • Mabey DC, Whittle HC. Genital and neonatal chlamydial infection in a trachoma endemic area. Lancet. 1982 Aug 7;2(8293):300–301. [PubMed]
  • Niamsanit S, Nunthapisud P, Limpongsanurak S. Prevalence of Chlamydia trachomatis among women attending an antenatal clinic in Bangkok. Southeast Asian J Trop Med Public Health. 1988 Dec;19(4):609–613. [PubMed]
  • Darougar S, Jones BR, Cornell L, Treharne JD, Dwyer RS, Aramesh B. Chlamydial urethral infection in Teheran. A study of male patients attending an STD clinic. Br J Vener Dis. 1982 Dec;58(6):374–376. [PMC free article] [PubMed]
  • Meheus A, Widy-Wirski R, D'Costa J, Van Dyck E, Delgadillo R, Piot P. Treatment of gonorrhoea in males in the Central African Republic with spectinomycin and procaine penicillin. Bull World Health Organ. 1984;62(1):89–94. [PMC free article] [PubMed]
  • Forsey T, Darougar S, Dines RJ, Wright DJ, Friedmann PS. Chlamydial genital infection in Addis Ababa, Ethiopia. A seroepidemiological survey. Br J Vener Dis. 1982 Dec;58(6):370–373. [PMC free article] [PubMed]
  • Darougar S, Forsey T, Osoba AO, Dines RJ, Adelusi B, Coker GO. Chlamydial genital infection in Ibadan, Nigeria. A seroepidemiological survey. Br J Vener Dis. 1982 Dec;58(6):366–369. [PMC free article] [PubMed]
  • Omer EE, Forsey T, Darougar S, Ali MH, el-Naeem HA. Seroepidemiological survey of chlamydial genital infections in Khartoum, Sudan. Genitourin Med. 1985 Aug;61(4):261–263. [PMC free article] [PubMed]
  • Hodgson JE, Shi YF, Gao YL, Wu KJ, Jiang BY, Chen YL. Chlamydial infection in a Chinese gynecologic outpatient clinic. Obstet Gynecol. 1988 Jan;71(1):96–100. [PubMed]
  • Chaudhuri P, Sng EH, Yuen WS. Chlamydia trachomatis infection in unmarried women seeking abortions. Genitourin Med. 1986 Feb;62(1):17–18. [PMC free article] [PubMed]
  • Blackmore CA, Limpakarnjanarat K, Rigau-Pérez JG, Albritton WL, Greenwood JR. An outbreak of chancroid in Orange County, California: descriptive epidemiology and disease-control measures. J Infect Dis. 1985 May;151(5):840–844. [PubMed]
  • Plummer FA, D'Costa LJ, Nsanze H, Dylewski J, Karasira P, Ronald AR. Epidemiology of chancroid and Haemophilus ducreyi in Nairobi, Kenya. Lancet. 1983 Dec 3;2(8362):1293–1295. [PubMed]
  • Goh CL. Chancroid--a review. Ann Acad Med Singapore. 1987 Oct;16(4):680–682. [PubMed]
  • Orellana-Díaz O, Hernández-Pérez E. Chancroid in El Salvador. Increasing incidence, clinical features, and therapeutics. Int J Dermatol. 1988 May;27(4):243–245. [PubMed]
  • Mabey DC, Wall RA, Bello CS. Aetiology of genital ulceration in the Gambia. Genitourin Med. 1987 Oct;63(5):312–315. [PMC free article] [PubMed]
  • D'Costa LJ, Bowmer I, Nsanze H, Dylewski J, Fransen L, Plummer FA, Piot P, Ronald AR. Advances in the diagnosis and management of chancroid. Sex Transm Dis. 1986 Jul-Sep;13(3 Suppl):189–191. [PubMed]
  • Sehgal VN, Prasad AL. Donovanosis. Current concepts. Int J Dermatol. 1986 Jan-Feb;25(1):8–16. [PubMed]
  • Adler MW. Trends for gonorrhea and pelvic inflammatory disease in England and Wales and for gonorrhea in a defined population. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):901–904. [PubMed]
  • Washington AE, Arno PS, Brooks MA. The economic cost of pelvic inflammatory disease. JAMA. 1986 Apr 4;255(13):1735–1738. [PubMed]
  • St John RK, Blount J, Jones O. Pelvic inflammatory disease in the United States. Incidence and trends in private practice. Sex Transm Dis. 1981 Apr-Jun;8(2):56–61. [PubMed]
  • Washington AE, Cates W, Jr, Zaidi AA. Hospitalizations for pelvic inflammatory disease. Epidemiology and trends in the United States, 1975 to 1981. JAMA. 1984 May 18;251(19):2529–2533. [PubMed]
  • Muir DG, Belsey MA. Pelvic inflammatory disease and its consequences in the developing world. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):913–928. [PubMed]
  • Burchell HJ, Welgemoed NC. Die mikrobiologiese etiologie van akute bekken- infektiewe siekte in Pelonomi-hospitaal, Bloemfontein. S Afr Med J. 1988 Jan 23;73(2):81–82. [PubMed]
  • Frost E, Collet M, Reniers J, Leclerc A, Ivanoff B, Meheus A. Importance of chlamydial antibodies in acute salpingitis in central Africa. Genitourin Med. 1987 Jun;63(3):176–178. [PMC free article] [PubMed]
  • Eschenbach DA, Wager GP. Puerperal infections. Clin Obstet Gynecol. 1980 Dec;23(4):1003–1037. [PubMed]
  • Sweet RL, Landers DV, Walker C, Schachter J. Chlamydia trachomatis infection and pregnancy outcome. Am J Obstet Gynecol. 1987 Apr;156(4):824–833. [PubMed]
  • Berman SM, Harrison HR, Boyce WT, Haffner WJ, Lewis M, Arthur JB. Low birth weight, prematurity, and postpartum endometritis. Association with prenatal cervical Mycoplasma hominis and Chlamydia trachomatis infections. JAMA. 1987 Mar 6;257(9):1189–1194. [PubMed]
  • Plummer FA, Laga M, Brunham RC, Piot P, Ronald AR, Bhullar V, Mati JY, Ndinya-Achola JO, Cheang M, Nsanze H. Postpartum upper genital tract infections in Nairobi, Kenya: epidemiology, etiology, and risk factors. J Infect Dis. 1987 Jul;156(1):92–98. [PubMed]
  • Lawson HW, Atrash HK, Saftlas AF, Franks AL, Finch EL, Hughes JM. Ectopic pregnancy surveillance, United States, 1970-1985. MMWR CDC Surveill Summ. 1988 Dec;37(5):9–18. [PubMed]
  • Hockin JC, Jessamine AG. Trends in ectopic pregnancy in Canada. Can Med Assoc J. 1984 Oct 1;131(7):737–740. [PMC free article] [PubMed]
  • Walker GJ, Ashley DE, McCaw AM, Bernard GW. Maternal mortality in Jamaica. Lancet. 1986 Mar 1;1(8479):486–488. [PubMed]
  • Cates W., Jr Sexually transmitted organisms and infertility: the proof of the pudding. Sex Transm Dis. 1984 Apr-Jun;11(2):113–116. [PubMed]
  • Cates W, Farley TM, Rowe PJ. Worldwide patterns of infertility: is Africa different? Lancet. 1985 Sep 14;2(8455):596–598. [PubMed]
  • Mputu L, Wolomby M, Mahekele K. La contribution de la composante masculine dans l'infertilité du couple à Kinshasa (Zaïre). J Gynecol Obstet Biol Reprod (Paris) 1986;15(1):51–58. [PubMed]
  • Guidelines for the prevention and control of congenital syphilis. MMWR Morb Mortal Wkly Rep. 1988 Jan 15;37 (Suppl 1):1–13. [PubMed]
  • Syphilis and congenital syphilis--United States, 1985-1988. MMWR Morb Mortal Wkly Rep. 1988 Aug 19;37(32):486–489. [PubMed]
  • Stray-Pedersen B. Economic evaluation of maternal screening to prevent congenital syphilis. Sex Transm Dis. 1983 Oct-Dec;10(4):167–172. [PubMed]
  • Schulz KF, Cates W, O'mara PR. A synopsis of the problems in Africa in syphilis and gonorrhoeae during pregnancy. Afr J Sex Transmi Dis. 1986 Oct;2(2):56–60. [PubMed]
  • Watts TE, Larsen SA, Brown ST. A case-control study of stillbirths at a teaching hospital in Zambia, 1979-80: serological investigations for selected infectious agents. Bull World Health Organ. 1984;62(5):803–808. [PMC free article] [PubMed]
  • Naeye RL, Tafari N, Marboe CC, Judge DM. Causes of perinatal mortality in an African city. Bull World Health Organ. 1977;55(1):63–65. [PMC free article] [PubMed]
  • Mabey D, Hanlon P, Hanlon L, Marsh V, Forsey T. Chlamydial and gonococcal ophthalmia neonatorum in The Gambia. Ann Trop Paediatr. 1987 Sep;7(3):177–180. [PubMed]
  • Galega FP, Heymann DL, Nasah BT. Gonococcal ophthalmia neonatorum: the case for prophylaxis in tropical Africa. Bull World Health Organ. 1984;62(1):95–98. [PMC free article] [PubMed]
  • Rapoza PA, Quinn TC, Kiessling LA, Green WR, Taylor HR. Assessment of neonatal conjunctivitis with a direct immunofluorescent monoclonal antibody stain for Chlamydia. JAMA. 1986 Jun 27;255(24):3369–3373. [PubMed]
  • Laga M, Plummer FA, Piot P, Datta P, Namaara W, Ndinya-Achola JO, Nzanze H, Maitha G, Ronald AR, Pamba HO, et al. Prophylaxis of gonococcal and chlamydial ophthalmia neonatorum. A comparison of silver nitrate and tetracycline. N Engl J Med. 1988 Mar 17;318(11):653–657. [PubMed]
  • Gravett MG, Nelson HP, DeRouen T, Critchlow C, Eschenbach DA, Holmes KK. Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome. JAMA. 1986 Oct 10;256(14):1899–1903. [PubMed]
  • Harrison HR, Alexander ER, Weinstein L, Lewis M, Nash M, Sim DA. Cervical Chlamydia trachomatis and mycoplasmal infections in pregnancy. Epidemiology and outcomes. JAMA. 1983 Oct 7;250(13):1721–1727. [PubMed]
  • Alexander ER, Harrison HR. Role of Chlamydia trachomatis in perinatal infection. Rev Infect Dis. 1983 Jul-Aug;5(4):713–719. [PubMed]
  • Bobitt JR, Damato JD, Sakakini J., Jr Perinatal complications in group B streptococcal carriers: a longitudinal study of prenatal patients. Am J Obstet Gynecol. 1985 Mar 15;151(6):711–717. [PubMed]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...