Sexually transmitted Infections in rural South Africa towards better control strategies

This dissertation reveals the significant disease burden of four sexually transmitted diseases (STD's) – Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis – for women in rural South Africa. Attention is paid to epidemiological factors, microbiological factors and the clinical treatment of these STD's. The current syndromic treatment strategy for these STD's in South Africa and other low-resource settings generates a limited amount of epidemiological data and leads to both under- and over-treatment of infections. The results of this dissertation stress the importance of extensive surveillance and an improved control strategy, particularly given the increasing levels of antibiotic resistance.