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Methods

The targeted sample size was 25 cases of each STI syndrome per PHC, which equated to 900 cases of each syndrome nationally. Surveillance was conducted for Male Urethritis Syndrome (MUS); Vaginal Discharge Syndrome (VDS) and Genital Ulcer Syndrome (GUS); and high-risk human papillomavirus (HPV) infection in adolescent girls and young women. The aetiological study commenced in April 2014 and ended in September 2015, which was the period of co-operative agreement between the NICD, NDoH and CDC. STI syndromes were diagnosed and classified in accordance with the newly revised 2014 national Standard Treatment Guidelines for STIs at Primary Health Care Centres. Eligible and consenting STI and family planning clinic attendees were enrolled anonymously into the survey, completed a healthcare worker administered questionnaire and provided relevant clinical specimens, which included genital swab specimens and blood samples. STI and family planning clinic attendees could have more than one syndrome diagnosed at enrolment. Laboratory testing was performed at the NICD’s STI Reference Laboratory at the Centre for HIV & STIs, as well as at the Institute of Infectious Disease and Molecular Medicine, University of Cape Town.