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This document highlights the diagnostics available now to support scale-up and expanded access to screening to meet the growing testing demands in LMICs. The document is intended to compliment the WHO STI Laboratory Manual. The focus of this landscape is on the technologies (tests, platforms and systems for use in resource-limited settings) commercially available at the time of publication for syphilis, chlamydia, gonorrhoea, trichomoniasis, mycoplasma, herpes, and HPV. This document does not provide market assessments or pipelines for new technologies but recognizes the need for additional complimentary documents to support decision makers in prioritizing STI testing in LMICs. The target audience for this document is broad but includes mainly national program managers.
This manual provides an authoritative guide to standard laboratory procedures for detecting and diagnosing sexually transmitted diseases. Addressed to clinical microbiologists and medical technologists, the manual is designed to serve as a practical bench aid, tuned to the needs and capacities of laboratories at different levels in the health system. Although the standard procedures described have universal relevance, particular attention is given to conditions in developing countries, where rapid transport of specimens may not be possible and cost factors may be decisive. Recommended procedures, tests, and techniques are supported by close to 150 references. Noting the constraints on staff and resources faced by most laboratories throughout the world, the manual concentrates on tests known to yield essential diagnostic information. Standard antimicrobial susceptibility tests are described for those diseases where drug resistance is a problem. Although the major emphasis is on procedures for diagnosis, case-finding, and test-of-cure, some procedures useful in epidemiological research are also included. The manual has nine chapter covering the full range of sexually transmitted diseases: gonorrhoea "Chlamydia trachomatis "infection, syphilis, genital herpes, chancroid granuloma inguinale, vaginitis in adults, human papillomavirus infection, and human immunodeficiency virus. Each chapter opens with a brief description of the disease and the principal laboratory approaches to diagnosis, followed by detailed advice on the collection and transport of specimens. Against this background, all relevant laboratory methods, from microscopy, culture and non-culture techniques to serology and the use of commercial test kits, are described in detail, with colour plates used to illustrate selected procedures and results. Apart from providing detailed step-by-step instructions for each procedure, the manual offers abundant practical advice on the selection of tests, their comparative sensitivity, and specificity, the degree of skill required, the correct interpretation of results, and common errors and how to avoid them. The chapter on HIV infection reproduces the latest joint UNAIDS and WHO recommendations for the selection and use of HIV antibody tests. Further practical guidance for each of these diseases is provided in three annexes, which summarize appropriate diagnostic tests at different levels of the laboratory system, describe the media, reagents, and stains required for the tests, and list all the basic products needed to prepare essential reagents and media.
One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
Multidisciplinary collection of essays on the relationship of infertility and the "historic" STIs--gonorrhea, chlamydia, and syphilis--producing surprising new insights in studies from across the globe and spanning millennia.
The objective of the list is to help countries develop or update their national essential diagnostics lists, raise awareness and political will, guide procurement and regulation policies and improve access to the most important in vitro diagnostics that all countries need to make available to their populations, particularly in low-resourced countries. It will also contribute towards health systems strengthening and realizing universal health coverage.
The WHO laboratory manual provides microbiologists and medical technologists with an up-to- date comprehensive guide on how to isolate, detect, and diagnose STIs, including HIV. The scope of the manual has been expanded to include chapters on the use of molecular tests, rapid point-of-care tests, and quality management of diagnostic tests and hence the manual will also be of interest to STI and HIV programme managers and clinical staff.
A comprehensive resource describing innovative technologies and digital health tools that can revolutionize the delivery of health care in low- to middle-income countries, particularly in remote rural impoverished communities Revolutionizing Tropical Medicine offers an up-to-date guide for healthcare and other professionals working in low-resource countries where access to health care facilities for diagnosis and treatment is challenging. Rather than suggesting the expensive solution of building new bricks and mortar clinics and hospitals and increasing the number of doctors and nurses in these deprived areas, the authors propose a complete change of mindset. They outline a number of ideas for improving healthcare including rapid diagnostic testing for infectious and non-infectious diseases at a point-of-care facility, together with low cost portable imaging devices. In addition, the authors recommend a change in the way in which health care is delivered. This approach requires task-shifting within the healthcare provision system so that nurses, laboratory technicians, pharmacists and others are trained in the newly available technologies, thus enabling faster and more appropriate triage for people requiring medical treatment. This text: Describes the current burden of communicable and non-communicable diseases in low- to middle-income countries throughout the world Describes the major advances in healthcare outcomes in low-to middle-income countries derived from implementation of the United Nations/World Health Organisation’s 2000 Millennium Development Goals Provides a review of inexpensive rapid diagnostic point-of-care tests for infectious diseases in low-resource countries, particularly for people living in remote rural areas Provides a review of other rapid point-of-care services for assessing hematological function, biochemical function, renal function, hepatic function and status including hepatitis, acid-base balance, sickle cell disease, severe acute malnutrition and spirometry Explores the use of low-cost portable imaging devices for use in remote rural areas including a novel method of examining the optic fundus using a smartphone and the extensive value of portable ultrasound scanning when x-ray facilities are not available Describes the use of telemedicine in the clinical management of both children and adults in remote rural settings Looks to the future of clinical management in remote impoverished rural settings using nucleic acid identification of pathogens, the use of nanoparticles for water purification, the use of drones, the use of pulse oximetry and the use of near-infrared spectroscopy Finally, it assesses the potential for future healthcare improvement in impoverished areas and how the United Nations/World Health Organization 2015 Sustainable Development Goals are approaching this. Written for physicians, infectious disease specialists, pathologists, radiologists, nurses, pharmacists and other health care workers, as well as government healthcare managers, Revolutionizing Tropical Medicine is a new up-to-date essential and realistic guide to treating and diagnosing patients in low-resource tropical countries based on new technologies.
The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included. The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexualityâ€"the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame. The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches. The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality. The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.