Is STI surveillance in England meeting the requirements of the 21st century? An evaluation of data from the South West Region.

This study evaluates two sexually transmitted infections (STI) surveillance systems' ability to provide relevant, accurate, and timely information to inform prevention and control activities in England, using data from the South West, the largest of the country's nine regions. The systems were evaluated in terms of timeliness of reporting to subsequent levels; frequency of reporting and feedback; completeness of information in the reports; and representativeness of the reports to the resident population. To determine the usefulness of the system for those responsible for taking public health action, semi-structured interviews of a sample of users of surveillance information were conducted. Timeliness of the two main surveillance systems, laboratory reports and returns from genito-urinary medicine clinics were poor. Completeness of the laboratory system was good for date of birth and sex, but poor for geographical markers. Of the 27 respondents that participated in the survey, only eight were satisfied with the level of detail in the surveillance data they received. Most stakeholders felt that the STI data they received was not representative of the population they served and not useful in responding to emerging problems. Faced with increasing incidence of STIs, existing STI surveillance systems in England are unable to provide adequate epidemiological data for the fulfilment of basic uses of public health surveillance at the local level. Surveillance is inadequate in timeliness, geographical coverage, representativeness, does not allow for the identification of risk factors and conceals variations in sex, ethnicity, and sexual behaviour. Disaggregate data with some geographical and risk-factor information would greatly enhance the usefulness of the data. The goal should be of access to real-time data.