Acceptability and efficacy of partner notification for curable sexually transmitted infections in sub-Saharan Africa: A systematic review

Abstract

Comprehensive case management of sexually transmitted infections (STIs) includes partner notification. We reviewed the recent literature evaluating the acceptability and efficacy of partner notification strategies (i.e. direct patient referral, provider referral, or expedited partner treatment) for curable STIs in sub-Saharan Africa. We conducted a systematic search following PRISMA guidelines: published January 2008 to June 2017 in the English language, study in sub-Saharan Africa, and discussion of any curable STI with an outcome on partner notification. We searched six electronic databases, conference abstracts, online clinical trial registries, and article bibliographies. The results showed that out of the 74 identified articles, 55 did not meet inclusion criteria. Of the 11 studies evaluating direct patient referral, the proportion of index cases ( n = 4163) who successfully notified sex partner(s) was 53% (range 23-95%). Among those who notified ( n = 1727), 25% (range 0–77%) had partner(s) that sought evaluation (95% CI 0.51–0.54; 95% CI 0.23–0.27). Both provider referral and expedited partner treatment had higher proportions of partner(s) who sought treatment ( n = 208, 69% and n = 44, 84%, respectively). Direct patient referral is the most commonly used and evaluated partner notification strategy for STIs in sub-Saharan Africa with mixed success. We recommend future research to investigate other strategies such as expedited partner treatment.