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The significance of reporting STIs - how do we stand in Croatia?

One of the key component for sexually transmitted infections (STI) prevention and control is reliable surveillance data on disease burden and trends. This data provides insight of the extent of the problem, enables evaluation of interventions and is crucial for global and national strategic directions that guides focused actions. In Croatia STI surveillance is integrated in surveillance of all communicable diseases which is regulated by law. The main data are case-based reports (notification of individual case/death). The system is universal, comprehensive and mandatory with national coverage. Reporting is obligatory for all physicians in private and public settings. Diseases covered: chlamydiasis, LGV, gonorrhoea, syphilis, congenital syphilis, hepatitis B (HBV), hepatitis C (HCV) and HIV/AIDS. The system is paper-based, partially with electronic online database. Enhanced surveillance exists for HIV/AIDS, for HBV/HCV is under development. Reporting is based on clinical diagnoses ; laboratory confirmation is required for HBV, HCV, HIV/AIDS and syphilis. Aditionally, there is system of reporting outbreaks. Strengths and opportunities of STI reporting are continuity ; case definitions harmonized with EU definitions ; functional public health institute network ; data triangulation ; global partnership (ECDC/WHO reporting network, EUROGASP, EU projects) ; collaboration of state and civil society organizations. Weaknesses and challenges are incomplete functioning, non-user-friendly e- reporting system ; underreporting ; laboratory tests not epi linked ; reducing stigma ; data visualization ; better feedback to clinicians ; poor use of epidemiological data in a systematic manner to manage and monitor the health sector response to STIs ; no national strategy/action plan for STIs. The existence of a discrepancy between reported STIs and other official and unofficial sources of STI incidence and prevalence from the health system suggests that there is room for improvement in quality of collecting, reporting, analyzing and using STI data. Further work is required to strengthen STI reporting since better data quality and monitoring epidemiological situation lead to timely and adequate interventions, better decision-making and development of effective prevention and control programmes.

sexually transmitted infections , STI, case reporting, surveillance, Croatia

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