Designing a comprehensive Sexually Transmitted Infections (STIs) surveillance system in Iran: tools, definitions, and implementation steps

Sexually transmitted infections (STIs) are a major public health concern globally, with significant implications for both individual and community health. Despite the prevalence of STIs in Iran, the existing surveillance system has been inefficient, with low reporting sensitivity and inadequate data quality. This study describes the implementation steps of designing an improved STI surveillance system in Iran, utilizing standardized tools, definitions, and operational protocols. A comprehensive STI surveillance system was developed for Iran based on the World Health Organization (WHO) guidelines, and practical design approaches were utilized to adapt the framework to the national context and address the shortcomings of the existing reporting system in 2024. The design process involved reviewing protocols, consultations with specialists, defining syndromic and etiological case criteria, and developing data collection tools. The system design also included selecting the type of surveillance system to implement, training staff, and using a national guideline for specimen handling and an electronic system. The system was tailored to fit within Iran’s healthcare infrastructure, ensuring national feasibility and alignment with cultural conditions. The improved STI surveillance system provided essential tools and definitions for its implementation, focusing on two core components: patient management and data management. Patient management includes structured history-taking, clinical evaluation, syndromic and etiological diagnosis, treatment, and follow-up, all recorded in an electronic system. Data management ensures data accuracy, completeness, and timeliness through regular validation and statistical analysis. Quarterly reports are generated to monitor system performance, and feedback is gathered through various communication channels to enhance the system’s efficiency continuously. The newly developed STI surveillance system is intended to improve in Iran’s capacity to monitor STI incidence and implement effective public health strategies. By aligning with international standards, it emphasizes accurate data collection and real-time monitoring to track trends, enhance diagnostic and treatment protocols, detect outbreaks, and assess antimicrobial resistance. The system’s success hinges on continued support, adequate resources, and collaboration between the public and private sectors. Future evaluations are necessary to assess its long-term impact on STI management and prevention.