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. 2021 Sep 7;21(1):1637.
doi: 10.1186/s12889-021-11630-x.

The impact of the COVID-19 pandemic on Sexually Transmitted Infections surveillance data: incidence drop or artefact?

Alexis Sentís #  1   2   3   4 , Albert Prats-Uribe #  5 , Evelin López-Corbeto  1   2 , Marcos Montoro-Fernandez  1 , Daniel Kwakye Nomah  1   6 , Patrícia Garcia de Olalla  2   7 , Lilas Mercuriali  7 , Núria Borrell  8 , Víctor Guadalupe-Fernández  9 , Juliana Reyes-Urueña  10   11 , Jordi Casabona  1   2   6 ; Catalan HIV and STI Surveillance Group
Collaborators, Affiliations

The impact of the COVID-19 pandemic on Sexually Transmitted Infections surveillance data: incidence drop or artefact?

Alexis Sentís et al. BMC Public Health. .

Abstract

Background: Before the COVID-19 pandemic, Sexually transmitted infections (STIs) were increasing in Europe, and Spain and Catalonia were not an exception. Catalonia has been one of the regions with the highest number of COVID-19 confirmed cases in Spain. The objective of this study was to estimate the magnitude of the decline, due to the COVID-19 pandemic, in the number of STI confirmed cases in Catalonia during the lockdown and de-escalation phases.

Methods: Interrupted time series analysis was performed to estimate the magnitude of decline in the number of STI reported confirmed cases - chlamydia, gonorrhoea, syphilis, and lymphogranuloma venereum- in Catalonia since lockdown with historical data, from March 13th to August 1st 2020, comparing the observed with the expected values.

Results: We found that since the start of COVID-19 pandemic the number of STI reported cases was 51% less than expected, reaching an average of 56% during lockdown (50% and 45% during de-escalation and new normality) with a maximum decrease of 72% for chlamydia and minimum of 22% for syphilis. Our results indicate that fewer STIs were reported in females, people living in more deprived areas, people with no previous STI episodes during the last three years, and in the HIV negative.

Conclusions: The STI notification sharp decline was maintained almost five months after lockdown started, well into the new normality. This fact can hardly be explained without significant underdiagnosis and underreporting. There is an urgent need to strengthen STI/HIV diagnostic programs and services, as well as surveillance, as the pandemic could be concealing the real size of the already described re-emergence of STIs in most of the European countries.

Keywords: COVID-19; Epidemiology; Interrupted time series; Lockdown; Public health; Sexually transmitted infections; Surveillance, communicable diseases; Trends.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Observed and expected time series trends of daily STI reported confirmed cases in Catalonia during the COVID-19 pandemic, August 1st 2017 - August 1st 2020 (dark grey: lockdown, light grey: de-escalation phases)
See this image and copyright information in PMC

References

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