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Home : Publications : CCDR : 2005 - Volume 31 : 31S2

2002 Canadian Sexually Transmitted Infections Surveillance Report

Supplement

June 2005 Volume 31S2
PDF Version PDF (1,249 KB)

2002 Canadian Sexually Transmitted Infections Surveillance Report

Table of Contents

Foreword
 
Executive Summary
Figure 1: Reported Cases of STI as a Proportion of all Notifiable Diseases in Canada, 2002
 
Genital Chlamydia
Table 1: Number of Reported Cases and Rates of Genital Chlamydia Infection in Canada, 1992, 1997 and 2002
Table 2: Reported cases and rates of Genital Chlamydia by province/territory
Table 3: Counts and Rates of Hospitalization for Ectopic Pregnancy by Year and Age Group, Canada, 1995-2000
 
Figure 1: Reported (Genital) Chlamydia Rates in Canada, 1992-2002
Figure 2: Reported Male (Genital) Chlamydia Rates in Canada by Selected Age Group, 1992-2002
Figure 3: Reported Female (Genital) Chlamydia Rates in Canada by Selected Age Group, 1992-2002
Figure 4: Reported Cases and Rates of Genital Chlamydia by Province/Territory, 2002
Figure 5: Reported Male Genital Chlamydia Rates in Canada by Province/Territory, 1997 and 2002
Figure 6: Reported Female Genital Chlamydia Rates in Canada by Province/Territory, 1997 and 2002
 
Gonorrhea
Table 1: Percentage Increase in Number of Reported Male Gonorrhea Cases, Canada, 1997-2002
Table 2: Percentage Increase in Number of Reported Famale Gonorrhea Cases, Canada, 1997-2002
Table 3: Reported Cases and Rates by Province/Territory
Table 4: Antimicrobial Susceptibility of N. Gonorrhoeae Strains Tested in Canada in 2002
 
Figure 1: Reported Gonorrhea Rates in Canada, 1980-2002
Figure 2: Reported Gonorrhea Rates in Canada by Sex and Age Group, 2002
Figure 3: Reported Male Gonorrhea Rates in Canada by Age Group, 1992-2002
Figure 4: Reported Female Gonorrhea Rates in Canada by Age Group, 1992-2002
Figure 5: Reported Cases and Rates of Gonorrhea in Canada by Province/Territory, 2002
Figure 6: Reported Rate of Gonorrhea by Sex and Province/Territory, 2002
Figure 7: Reported Male Gonorrhea Rates in Canada by Province/Territory, 1997 and 2002
Figure 8: Reported Female Gonorrhea Rates in Canada by Province/Territory, 1997 and 2002
 
Infectious Syphilis
Table 1: Percentage Increase in Number of Reported Male Syphilis Cases, Canada, 1997-2002
Table 2: Percentage Increase in Number of Reported Female Syphilis Cases, Canada, 1997-2002
Table 3: "Syphilis-Free Status" by 3-Year Interval and Province/Territory, Canada, 1994-2002
 
Figure 1: Reported Infectious Syphilis Rates in Canada, 1993-2002
Figure 2: Reported Rate of Infectious Syphilis by Sex and Age Group, 2002
Figure 3: Reported Rates of Infectious Syphilis in Males, 1997 and 2002
Figure 4: Age Distribution of Reported Infectious Syphilis Cases in MSM, Canada, 1994-2002
Figure 5: Reported Rate of Infectious Syphilis among Females, by Age, 1997 and 2002
Figure 6: Reported Infectious Syphilis Cases and Rates in Canada by Province/Territory and Sex, 1993-2002
Figure 7: Reported Rates of Infectious Syphilis among Males by Province/Territory, 1997 and 2002
Figure 8: Reported Rates of Infectious Syphilis among Females by Province/Territory, 1997 and 2002
 
Technical Notes
 
References
 
Appendix 1
Table 1.1: Reported Genital Chlamydia Cases and Rates in Canada by Age Group and Sex, 1991-2002
Table1.2: Reported Genital Chlamydia Cases and Rates in Canada by Province/Territory and Sex, 1991-2002
Table 2.1: Reported Gonorrhea Cases and Rates in Canada by Age Group and Sex, 1980-2002
Table 2.2: Reported Gonorrhea Cases and Rates in Canada by Province/Territory and Sex, 1980-2002
Table 3.1: Reported Infectious Syphilis Cases and Rates in Canda by Age Group and Sex, 1993-2002
Table 3.2: Reported Infectious Syphilis Cases and Rates in Canada by Province/Territory and Sex, 1993-2002

Foreword

The Sexual Health and Sexually Transmitted Infections section of the Public Health Agency of Canada is pleased to provide you with this latest version of the Sexually Transmitted Infections (STI) Surveillance Report. The term STI (sexually transmitted infection), now commonly used in place of STD (sexually transmitted disease), is more encompassing and includes infections that may be asymptomatic.

The timing of this report is ideal, as the Sexual Health and Sexually Transmitted Infections section is currently revising the national STI goals set in 1996, as well as revising the 1998 Canadian STD Guidelines. In addition, this section has continued its development of the Minimum Dataset in collaboration with the provinces and territories. Such a dataset would enhance the consistency and timeliness of data submission at the national level. However, none of these can be done effectively without a knowledge of the current national STI picture.

This publication focuses on basic epidemiologic information for diseases that are transmitted predominantly through sexual contact and that are nationally reportable to the Public Health Agency of Canada. The list of nationally reportable diseases was determined by a federal/provincial/territorial committee using a priority-setting process to determine which diseases should be routinely monitored. Criteria were developed with the objective of ensuring the best use of resources in the prevention and control of diseases that are a threat to Canadians. The STI included in this list are genital chlamydia, gonorrhea, and infectious syphilis. Other infections, such as genital herpes and human papillomavirus, are not reportable and therefore not included.

This report on Canadian trends in STI is intended for governments, health professionals, researchers, voluntary agencies that are involved in service provision and planning, and the general public. The goal is to provide information that can be used to support and inform decision-making and programs aimed at improving the health of Canadians.

All surveillance systems have limitations; the following are the ones noted for our system. Many STI are asymptomatic, therefore some infections may go unnoticed, undiagnosed, and unreported. Furthermore, contact tracing is a critical activity in the prevention and control of STI, but recent increases in risky sexual behaviour, such as anonymous sex partnering, make contact tracing difficult. As a result, infections among anonymous contacts of cases may not be recognized and entered into the surveillance system. Among symptomatic individuals, only those who seek testing or medical care will be captured by this passive surveillance system. Because of these limitations, the counts in this report are likely an underestimate of the true burden of disease. However, the report does provide an estimate of the scope and trends of STI in Canada. Data up to 2001 have been finalized, but 2002 data are still subject to change because of reporting delays and other constraints of surveillance systems.

When reading this report, please keep in mind that small variability may exist between data reported by the Public Health Agency of Canada and data reported by individual provinces and territories. In such circumstances, provincial/territorial data are definitive, as their data are the most up to date.

This report, as well as our ongoing surveillance of STI, could not happen without the efforts of so many others:

  • the Surveillance and Risk Assessment Division within the Public Health Agency of Canada, which maintains the Infectious Disease Reporting System from which counts of bacterial STI are derived;
  • the National Microbiology Laboratory in Winnipeg, which provides data on antibiotic-resistant gonorrhea and has also contributed to sections of this report;
  • the Data Development and Exchange Program at the Public Health Agency of Canada, which provided data on pelvic inflammatory disease as well as estimates of the number of births in Canada;
  • the Field Surveillance Officers, located in several provinces and territories, who assist with data quality improvement and provide ongoing support to the Sexual Health and Sexually Transmitted Infections section;
  • provincial and territorial health ministries. We gratefully acknowledge them for the timely manner in which they provide data to the Public Health Agency of Canada for their continued expert contributions to the national STI program.

Maureen Perrin, BA, ITMD
Senior Surveillance Analyst
Sexual Health and STI
Community Acquired Infections Division
Centre for Infectious Disease Prevention and Control

Cara Bowman, MHSc
Surveillance Analyst
Sexual Health and STI
Community Acquired Infections Division
Centre for Infectious Disease Prevention and Control

Susanne Shields, MSc
Head, STI and Behavioural Surveillance
Sexual Health and STI
Community Acquired Infections Division
Centre for Infectious Disease Prevention and Control

Barbara Jones
Acting Manager
Sexual Health and STI
Community Acquired Infections Division
Centre for Infectious Disease Prevention and Control

Thomas Wong, MD, MPH, CCFP, FRCPC
Director
Community Acquired Infections Division
Centre for Infectious Disease Prevention and Control

Executive Summary

Since the last report, there have been continued increases in all three nationally reportable sexually transmitted infections (STI): chlamydia, gonorrhea, and infectious syphilis. This upward trend in STI rates has been reported since 1997.

The trend of increasing STI rates is one that has been reported to varying degrees in other industrialized countries. In the United Kingdom, rates of chlamydia infection have been rising since 1996 and those for gonorrhea infection since 1995(1). In 2002, rates of infectious syphilis were 73% higher among males and 33% higher among females than 2001(1). With an exception in 2000, rates of chlamydia infection in the United States have risen steadily since 1996(2). However, unlike Canada, where rates have been steadily rising since 1998, rates of gonorrhea in the United States in 2002 were the lowest they had been in the previous 4 years. Also in the United States, rates of infectious syphilis have increased by 12.4% from 2001, which is much lower than the 66.7% increase observed in Canada.

There were 56 241 cases of genital chlamydia in 2002, for a rate of 179.3 per 100 000 population. This represents an 11.1% increase compared with the rate of 161.4 per 100 000 in 2001 and a 57.5% increase above the rate in 1997. The number of reported cases of gonorrhea in 2002 was 7 367, for a rate of 23.5 per 100 000 population. This represents an increase of 7.9% compared with the 2001 rate of 21.8 per 100 000 and an increase of 57.3% compared with the rate in 1997. In 2002, there were 463 cases of infectious syphilis reported, for a rate of 1.5 per 100 000 population. This rate is 66.7% higher than that reported in 2001 (0.9 per 100 000 population) and 284.9% higher than the rate reported in 1997. However, the percentage increase associated with infectious syphilis (compared with chlamydia and gonorrhea) must be interpreted with caution, as the case counts and rates of infectious syphilis are very small.

With a few exceptions, patterns of STI infection related to gender have remained fairly consistent. Women continue to be disproportionately affected by chlamydia infection. Rates of gonorrhea and syphilis infection are still higher among men. For both chlamydia and gonorrhea, the males and females most at risk of infection are those between the ages of 15 and 29. The picture for syphilis, however, has changed. Among females, those most at risk continue to be between the ages of 20 and 39, whereas the males most at risk are between the ages of 25 and 59, those in the 30 to 39 age group being at greatest risk.

In 2002, reported cases of chlamydia, gonorrhea, and syphilis accounted for 51% of all notifiable disease cases reported to Health Canada. This proportion has remained relatively stable over the years.

Figure 1: Reported Cases of STI as a Proportion of All Notifiable Diseases in Canada, 2002*

Reported Cases of STI as a Proportion of all Notifiable Diseases in Canada, 2002

* Preliminary data
Source: Notifiable Diseases, Surveillance and Risk Assessment Division, Public Health Agency of Canada, 2004

 

June 2005 Volume 31S2
PDF Version PDF (1,249 KB)

 
Last Updated: 2005-08-16 Top
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