Epidemiology and determinants of reemerging bacterial sexually transmitted infections (STIs) and emerging STIs in Europe

Oriol Mitjà; Valeska Padovese; Cinta Folch; Isotta Rossoni; Michael Marks; Miquel Angel Rodríguez I Arias; Amalio Telenti; Angela Ciuffi; Karel Blondeel; Otilia Mårdh; Jordi Casabona

doi:10.1016/j.lanepe.2023.100742

Epidemiology and determinants of reemerging bacterial sexually transmitted infections (STIs) and emerging STIs in Europe

Lancet Reg Health Eur. 2023 Oct 26:34:100742. doi: 10.1016/j.lanepe.2023.100742. eCollection 2023 Nov.

Authors

Oriol Mitjà^{1

2

3}, Valeska Padovese⁴, Cinta Folch^{5

6

7}, Isotta Rossoni⁸, Michael Marks^{9

10

11}, Miquel Angel Rodríguez I Arias^{1

2}, Amalio Telenti¹², Angela Ciuffi¹³, Karel Blondeel¹⁴, Otilia Mårdh¹⁵, Jordi Casabona^{5

6

7}

Affiliations

¹ Skin Neglected Tropical Diseases and Sexually Transmitted Infections Section, Hospital Universitari Germans Trías i Pujol, Badalona, Spain.
² Fight Infectious Diseases Foundation, Badalona, Spain.
³ School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
⁴ Genitourinary Clinic, Department of Dermatology and Venereology, Mater Dei Hospital, Msida, Malta.
⁵ Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.
⁶ Germans Trias I Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain.
⁷ CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
⁸ Van Vollenhoven Institute for Law, Governance and Society, Leiden University, Netherland.
⁹ Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, United Kingdom.
¹⁰ Division of Infection and Immunology, University College London, London, UK.
¹¹ Hospital for Tropical Diseases, University College London Hospital, London, UK.
¹² Scripps Research, La Jolla, CA, 92037, USA.
¹³ Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
¹⁴ Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
¹⁵ STI, Blood Borne Viruses and TB Section, Disease Programmes Unit, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden.

Abstract

In this scoping review, we offer a comprehensive understanding of the current and recent epidemiology, challenges, and emerging issues related to bacterial sexually transmitted infections (STIs) in the WHO European Region. We endeavour in collating data from both EU/EEA and non- EU/EEA countries, thereby giving a complete picture of the region which highlights the higher notification rates in Northern and Western countries than other regions, likely due to differences in testing, access to testing, and surveillance capacity. We provide an up-to-date review on the current knowledge of determinants and persistent inequities in key populations as well as the use of molecular epidemiology for identifying transmission networks in gonorrhoea and syphilis, and detecting chlamydia mutations that evade molecular diagnosis. Finally, we explore the emerging STIs in the region and the evolving transmission routes of food and waterborne diseases into sexual transmission. Our findings call for harmonized STI surveillance systems, proactive strategies, and policies to address social factors, and staying vigilant for emerging STIs.

Keywords: Chlamydia; Emerging; Epidemiology; Europe; Gonorrhoea; Key populations; Men who have sex with men; Sexually transmitted infections; Syphilis.

Publication types

Review