Trends in the epidemiology of bacterial sexually transmitted infections in eastern Europe, 1995-2005.

BACKGROUND: Sexually transmitted infections (STI) are a significant public health problem both worldwide and in Europe. This article reviews trends in the epidemiology of the major bacterial STI in eastern European countries, their key determinants, as well as challenges and opportunities for enhancing STI control in the region. SEARCH STRATEGY: Publications were sought through computerised searches in PubMed from 1995 to 2008 using using free text and relevant medical subject headings with no language restrictions. Conference abstracts and other unpublished manuscripts were excluded. RESULTS: The reported rates of STI in many eastern European countries have either decreased (syphilis and gonorrhoea in the eastern/Russian regions, gonorrhoea throughout eastern Europe) or been relatively stable (syphilis in the southeastern region, chlamydia throughout eastern Europe), in the past decade, but are still significantly higher than in western Europe. There is a significant east-west geopolitical gradient in reported STI rates throughout eastern Europe (STI rates: Russia/eastern region>>southeastern region>central region). Challenges for STI control include: the need to strengthen public health components of control; improvements in surveillance and improvement, as well as quality assurance, in diagnostic strategies. Gains in STI control may be achieved through greater collaboration and harmonisation of practicss at the European level.

The validity of survey responses on abortion: evidence from Estonia.

This paper presents results of a validation survey of abortion conducted in Tallinn, Estonia in April and May 1992. The sample was drawn from patient records in a maternity hospital. Women who had an abortion in that hospital in 1991 were asked about recent abortions as part of a survey about women's health. More than 80% of the respondents reported having a recent abortion. Some respondents misreported their abortion as a miscarriage. Moreover, some variation in reporting was associated with respondents' characteristics. Ethnic Estonians were less likely to report their abortion than were Russians, women over age 40 were less likely to report the abortion than younger women, and women who had the abortion late in the first trimester were less likely to report that abortion. There was some evidence that unmarried women were less likely than married women to report their abortion, and that women who had borne three or more children were less likely to report their abortion than women who had borne fewer children. These differences probably stem from the extent to which pregnancy or abortion is considered stigmatizing for women in different situations.