Guidelines for the management of asymptomatic sexually transmitted infections: web annex: evidence-to-decision framework and systematic review for the management of asymptomatic sexually transmitted infections
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World Health Organization
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iii, 98 p.
This web annex accompanies the WHO Guidelines for the management of asymptomatic sexually transmitted infections and presents the evidence-to-decision frameworks, systematic reviews and modelling analyses used to inform WHO recommendations on screening for asymptomatic sexually transmitted infections (STIs). The publication focuses primarily on screening for Neisseria gonorrhoeae and Chlamydia trachomatis among specific populations, including pregnant women, sexually active adolescents and young people, sex workers and men who have sex with men. It summarizes evidence on screening strategies, diagnostic accuracy, treatment outcomes, STI transmission, adverse reproductive and neonatal outcomes, feasibility, acceptability, equity, resource requirements and cost–effectiveness in different epidemiological and resource settings. The document describes the methods and findings of systematic literature reviews, evidence assessments and modelling studies evaluating molecular assays, point-of-care tests, culture and risk assessment approaches. It presents the deliberations and judgements of the WHO Guideline Development Group regarding the balance of benefits and harms associated with asymptomatic STI screening, particularly in settings with high prevalence and available resources. The publication also highlights implementation considerations, including antimicrobial resistance, stigma, access to testing technologies, health system capacity and the importance of voluntary screening with informed consent.
This web annex accompanies the WHO Guidelines for the management of asymptomatic sexually transmitted infections and presents the evidence-to-decision frameworks, systematic reviews and modelling analyses used to inform WHO recommendations on screening for asymptomatic sexually transmitted infections (STIs). The publication focuses primarily on screening for Neisseria gonorrhoeae and Chlamydia trachomatis among specific populations, including pregnant women, sexually active adolescents and young people, sex workers and men who have sex with men. It summarizes evidence on screening strategies, diagnostic accuracy, treatment outcomes, STI transmission, adverse reproductive and neonatal outcomes, feasibility, acceptability, equity, resource requirements and cost–effectiveness in different epidemiological and resource settings. The document describes the methods and findings of systematic literature reviews, evidence assessments and modelling studies evaluating molecular assays, point-of-care tests, culture and risk assessment approaches. It presents the deliberations and judgements of the WHO Guideline Development Group regarding the balance of benefits and harms associated with asymptomatic STI screening, particularly in settings with high prevalence and available resources. The publication also highlights implementation considerations, including antimicrobial resistance, stigma, access to testing technologies, health system capacity and the importance of voluntary screening with informed consent.
Keywords
Sexually Transmitted Diseases, Asymptomatic Diseases, Mass Screening, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Gonorrhea, Syphilis, HIV Infections, Anti-Bacterial Agents, Antimicrobial Resistance, Drug Resistance, Bacterial, Adolescent, Young Adult, Sex Workers, Homosexuality, Male, Evidence-Based Practice, Systematic Reviews as Topic, Decision Support Techniques, Models, Theoretical, Trachoma, Pregnancy, Pregnancy Complications, World Health Organization, Sexual Partners, Guidelines as Topic, prevention and control, diagnosis