Assessment of Sexually Transmitted Infections Surveillance System in Iraq

Background: Sexually transmitted infections (STIs) continue to pose significant public health challenges worldwide. This study aimed to assess the STI surveillance system in Iraq, including the Kurdistan Region, to identify gaps and areas for improvement. Subjects and Methods: A cross-sectional study was conducted from March 12 to October 1, 2023. A total of 116 health facilities (HFs), including HIV control sections, Primary Health Care Centers (PHCCs), and hospitals, across 20 Directorates of Health (DOH) were included in the assessment. A structured questionnaire was developed by the researchers and administered through interviews. The questionnaire collected demographic, surveillance data, and service characteristics. Results: The study assessed 116 HFs, comprising 345 units (surveillance, clinic, and laboratory (Lab)). Most peripheral-level surveillance units faced significant shortages in logistical resources. The timely submission of STI reports to the next health level was below the 85% target across all health levels. HIV control sections investigated 35% of reported cases, of which 35% had complete data. Data cleaning processes were completed by 11% of PHCCs and 0% of hospitals. National STI guidelines were in 50% of PHCCs and 35% of hospitals. The percentage of diagnosed cases meeting the definitions was 36% in PHCCs and 30% in hospitals. STI records were found in 80% of PHCCs and 45% of hospitals. Syphilis testing was available in 47% of PHCCs and 29% of hospitals. Conclusions: The STIs surveillance system at both peripheral and intermediate levels is inadequately managed, with significant gaps in resource allocation, training, and data management.