WHO releases new guidance to improve testing and diagnosis of sexually transmitted infections

The World Health Organization (WHO) is sharing its latest guidance on sexually transmitted infections (STIs) at the STI & HIV 2023 World Congress in Chicago, USA, from 24-27 July 2023. With STIs on the rise, the WHO is advocating for improved access to testing and diagnostic services. During the COVID-19 pandemic, many countries experienced low coverage for STI prevention, testing, and treatment services, leading to a global resurgence of STIs. Even countries with robust STI surveillance, like the United States and the United Kingdom, are reporting increasing STI cases. Emerging outbreaks of new infections, such as mpox, and the re-emergence of neglected STIs present challenges for prevention and control efforts.

One concerning issue is the growing failure of current treatment recommendations for gonorrhoea. A highly resistant Neisseria gonorrhoea clone that shows resistance to ceftriaxone is increasingly spreading in Asian countries like China, Japan, Singapore, and Vietnam, as well as in Australia, Austria, Canada, Denmark, France, Ireland, and the United Kingdom. The enhanced gonorrhoea antimicrobial resistance surveillance suggests high rates of resistance to current treatment options like ceftriaxone, cefixime, and azithromycin in places like Cambodia. Additionally, syphilis and congenital syphilis cases are on the rise, posing challenges due to the lack of benzathine penicillin, which is essential for effective treatment.

To address the growing STI problem, the WHO has issued new guidance on testing and laboratory diagnostics. They have developed target product profiles (TPPs) for point-of-care diagnostic technologies to diagnose syphilis (treponema pallidum), Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. The aim is to facilitate the development of quality STI diagnostics that are affordable and accessible in low- and middle-income countries (LMICs). Point-of-care tests can lead to lower healthcare costs, reduced waiting times, faster initiation of treatment, increased treatment accuracy, and improved patient follow-up.

The fourth edition of the Laboratory and point-of-care diagnostic testing for STIs, including HIV, offers up-to-date information on how to isolate, detect, and diagnose STIs. The manual now includes information on the use of molecular tests, rapid point-of-care tests, and quality management of diagnostic tests.

Furthermore, the Diagnostics Landscape for Sexually Transmitted Infections (STIs) highlights available diagnostics to support the scaling up of screening for various STIs in LMICs. This complements the aforementioned manual.

Dr. Meg Doherty, Director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, emphasizes the need for new, resilient, and adaptable models of STI services to address current and future challenges. Recent scientific advances in STI treatment and technologies, along with innovative service delivery methods, present an opportunity to end STIs as a public health concern by 2030. However, discrepancies in investment, maturity, and performance of STI surveillance systems among countries remain a challenge.

In May 2022, the 75th World Health Assembly approved the implementation of the new Global Health Sector Strategies for HIV, viral hepatitis, and sexually transmitted infections for the period 2022-2030 (GHSS). These strategies provide the strategic direction to tackle the current challenges in STI control. it is essential to note that there is no outright cure for all sexually transmitted infections (STIs). However, many STIs can be effectively treated and managed with appropriate medical care. It's crucial to seek medical attention promptly if you suspect you have an STI or if you've been exposed to one.

The specific treatment for each STI depends on the type of infection. Common STIs and their treatments include:

Chlamydia: Chlamydia is often treated with antibiotics such as azithromycin or doxycycline.

Gonorrhea: Gonorrhea is usually treated with antibiotics like ceftriaxone or cefixime, often in combination with azithromycin or doxycycline to cover possible co-infections.

Syphilis: Syphilis can be treated with penicillin or other antibiotics, depending on the stage of the infection.

Human Papillomavirus (HPV): There is no cure for HPV, but vaccines are available to prevent certain strains of the virus that can cause cervical cancer and genital warts.

Herpes Simplex Virus (HSV): There is no cure for HSV, but antiviral medications like acyclovir, valacyclovir, or famciclovir can help manage outbreaks and reduce their frequency.

HIV (Human Immunodeficiency Virus): While there is no cure for HIV, antiretroviral therapy (ART) can effectively control the virus, allowing individuals with HIV to live long and healthy lives.

Remember, early detection and treatment are crucial in managing STIs and preventing complications. If you suspect you have an STI or have had unprotected sexual contact, it's essential to get tested and speak with a healthcare professional. They can provide you with accurate information, proper diagnosis, and the most appropriate treatment for your specific situation. Additionally, always practice safe sex and use barrier methods like condoms to reduce the risk of STI transmission.

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