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Self-administered home-based tests are increasingly used as the primary method to detect SARS-CoV-2, the virus that causes COVID-19 (1). In contrast to tests performed at a public health department, laboratory, [...]

Objective: Case investigation and contact tracing (CI/CT) are fundamental public health efforts widely used during the COVID-19 pandemic to mitigate transmission. This study investigated how state, local, and tribal public health departments used CI/CT during the COVID-19 pandemic, including CI/CT methodology, staffing models, training and support, and efforts to identify or prioritize populations disproportionately affected by COVID-19. Methods: During March and April 2022, we conducted key informant interviews with up to 3 public health officials from 43 state, local, and tribal public health departments. From audio-recorded and transcribed interviews, we used the framework method to analyze key themes. Results: Major adjustments to CI/CT protocols during the pandemic included (1) prioritizing populations for outreach; (2) implementing automated outreach for nonprioritized groups, particularly during COVID-19 surges; (3) discontinuing contact tracing and focusing exclusively on case investigation; and (4) adding innovations to provide additional support. Key informants also discussed the utility of having backup staffing to support overwhelmed public health departments and spoke to the difficulty in "right-sizing" the public health workforce, with COVID-19 surges leaving public health departments understaffed as case rates rose and overstaffed as case rates fell. Conclusions: When addressing future epidemics or outbreaks, public health officials should consider strategies that improve the effectiveness of CI/CT efforts over time, such as prioritizing populations based on disproportionate risk, implementing automated outreach, developing models that provide flexible additional staffing resources as cases rise and fall among local public health departments, incorporating demographic data in laboratory reporting, providing community connections and support, and having a system of self-notification of contacts. [ABSTRACT FROM AUTHOR]

Triple elimination is an initiative supporting the elimination of mother-to-child transmission of three diseases--human immunodeficiency virus (HIV) infection, syphilis and hepatitis B. Significant progress towards triple elimination has been made in some regions, but progress has been slow in sub-Saharan Africa, the region with the highest burden of these diseases. The shared features of the three diseases, including their epidemiology, disease interactions and core interventions for tackling them, enable an integrated healthsystems approach for elimination of mother-to-child transmission. Current barriers to triple elimination in sub-Saharan Africa include a lack of policies, strategies and resources to support the uptake of well established preventive and treatment interventions. While much can be achieved with existing tools, the development of new products and models of care, as well as a prioritized research agenda, are needed to accelerate progress on triple elimination in sub-Saharan Africa. In this paper we aim to show that health systems working together with communities in sub-Saharan Africa could deliver rapid and sustainable results towards the elimination of mother-to-child transmission of all three diseases. However, stronger political support, expansion of evidence-based interventions and better use of funding streams are needed to improve efficiency and build on the successes in prevention of mother-to-child transmission of HIV. Triple elimination is a strategic opportunity to reduce the morbidity and mortality from HIV infection, syphilis and hepatitis B for mothers and their infants within the context of universal health coverage. La triple elimination est une initiative visant a soutenir l'eradication de la transmission mere-enfant de trois maladies - l'infection au virus de l'immunodeficience humaine (VIH), la syphilis et l'hepatite B. Bien que des avancees considerables aient ete observees en ce sens dans certaines regions, les progres demeurent lents en Afrique subsaharienne, pourtant durement touchee par ces maladies. Les caracteristiques communes aux trois affections, notamment leur epidemiologie, les interactions entre elles et les principales interventions necessaires a leur prise en charge permettent aux systemes de sante d'adopter une approche integree pour eviter la transmission mere-enfant. Plusieurs obstacles entravent actuellement la triple elimination en Afrique subsaharienne, parmi lesquels l'absence de politiques, de strategies et de ressources pour garantir la disponibilite de traitements preventifs et curatifs bien etablis. Les outils existants offrent deja de nombreuses solutions; mais pour accelerer la progression de cette triple elimination en Afrique subsaharienne, il est indispensable de developper de nouveaux produits et modeles de soins, ainsi qu'un programme de recherche prioritaire. Dans le present document, nous voulons montrer que si les systemes de sante collaborent avec les communautes en Afrique subsaharienne, ils pourront obtenir des resultats rapides et durables en vue d'eradiquer la transmission mere-enfant des trois maladies susmentionnees. Neanmoins, une telle demarche implique un soutien politique massif, l'expansion des interventions fondees sur des donnees scientifiques, et une meilleure utilisation des sources de financement afin d'ameliorer l'efficacite et de s'appuyer sur les reussites en matiere de prevention de la transmission du VIH de la mere a l'enfant. La triple elimination represente une occasion strategique de reduire la morbidite et la mortalite liees a l'infection au VIH, a la syphilis et a l'hepatite B, tant chez les meres que chez les nourrissons, dans un contexte de couverture maladie universelle. La triple eliminacion es una iniciativa que apoya la eliminacion de la transmision maternoinfantil de tres enfermedades: la infeccion por el virus de la inmunodeficiencia humana (VIH), la sifilis y la hepatitis B. En algunas regiones se han logrado avances significativos hacia la triple eliminacion, pero los progresos se han desarrollado con mayor lentitud en el Africa subsahariana, la region con la mayor carga de estas enfermedades. Las caracteristicas comunes de las tres enfermedades, como su epidemiologia, las interacciones entre ellas y las intervenciones basicas para combatirlas, permiten un enfoque integrado de los sistemas de salud para la eliminacion de la transmision maternoinfantil. Los obstaculos actuales para la triple eliminacion en el Africa subsahariana incluyen la falta de politicas, estrategias y recursos para apoyar la adopcion de intervenciones preventivas y de tratamiento bien establecidas. Aunque se puede lograr mucho con las herramientas existentes, se necesita el desarrollo de nuevos productos y modelos de atencion, asi como una agenda de investigacion prioritaria, para acelerar el progreso de la triple eliminacion en el Africa subsahariana. En este documento pretendemos demostrar que los sistemas de salud que trabajan conjuntamente con las comunidades del Africa subsahariana podrian obtener resultados rapidos y sostenibles hacia la eliminacion de la transmision maternoinfantil de las tres enfermedades. Sin embargo, se necesita un mayor apoyo politico, la ampliacion de las intervenciones basadas en la evidencia y un mejor uso de los flujos de financiacion para mejorar la eficiencia y aprovechar los exitos en la prevencion de la transmision maternoinfantil del VIH. La triple eliminacion es una oportunidad estrategica para reducir la morbilidad y la mortalidad de la infeccion por el VIH, la sifilis y la hepatitis B para las madres y sus hijos en el contexto de la cobertura sanitaria universal., Triple elimination Triple elimination is the elimination of mother-to-child transmission of three infections prevalent in low- and middle-income countries--human immunodeficiency virus (HIV), syphilis and hepatitis B virus. The African Region [...]

Syphilis is a sexually transmitted infection that can be passed from mother to infant during pregnancy and childbirth. Mother-to-child transmission (MTCT) of syphilis results in congenital syphilis (CS), which can [...]

Benzathine benzylpenicillin is a globally indispensable medicine. As a long-lasting injectable penicillin, it serves as the primary treatment for syphilis, group A streptococcal infections, rheumatic fever and rheumatic heart disease. A competitive market and low profit margins, compounded by limited visibility of demand, have resulted in a decreased number of active pharmaceutical ingredient (API) manufacturers. By 2016, only three Chinese API manufacturers remained, continuing to supply to the global market today. Recurring global shortages, a consequence of supply and demand imbalances, indicate underlying market risks. Therefore, the need for mitigation strategies is imperative. [ABSTRACT FROM AUTHOR]

Objective To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15-49 years, in 2016. Methods For chlamydia, gonorrhoea and trichomoniasis, we systematically searched for studies conducted between 2009 and 2016 reporting prevalence. We also consulted regional experts. To generate estimates, we used Bayesian meta-analysis. For syphilis, we aggregated the national estimates generated by using Spectrum-STI. Findings For chlamydia, gonorrhoea and/or trichomoniasis, 130 studies were eligible. For syphilis, the Spectrum-STI database contained 978 data points for the same period. The 2016 global prevalence estimates in women were: chlamydia 3.8% (95% uncertainty interval, UI: 3.3-4.5); gonorrhoea 0.9% (95% UI: 0.7-1.1); trichomoniasis 5.3% (95% UI:4.0-7.2); and syphilis 0.5% (95% UI: 0.4-0.6). In men prevalence estimates were: chlamydia 2.7% (95% UI: 1.9-3.7); gonorrhoea 0.7% (95% UI: 0.5-1.1); trichomoniasis 0.6% (95% UI: 0.4- 0.9); and syphilis 0.5% (95% UI: 0.4-0.6). Total estimated incident cases were 376.4 million: 127.2 million (95% UI: 95.1-165.9 million) chlamydia cases; 86.9 million (95% UI: 58.6-123.4 million) gonorrhoea cases; 156.0 million (95% UI: 103.4-231.2 million) trichomoniasis cases; and 6.3 million (95% UI: 5.5-7.1 million) syphilis cases. Conclusion Global estimates of prevalence and incidence of these four curable sexually transmitted infections remain high. The study highlights the need to expand data collection efforts at country level and provides an initial baseline for monitoring progress of the World Health Organization global health sector strategy on sexually transmitted infections 2016-2021. Objectif Produire des estimations de la prevalence et de l'incidence mondiales des infections urogenitales dues a la chlamydiose, a la gonorrhee, a la trichomonase et a la syphilis chez les femmes et les hommes de 15 a 49 ans, en 2016. Methodes Pour la chlamydiose, la gonorrhee et la trichomonase, nous avons systematiquement recherche les etudes menees entre 2009 et 2016 qui s'interessaient a la prevalence. Nous avons egalement consulte des experts regionaux. Pour produire des estimations, nous avons eu recours a une meta-analyse bayesienne. Pour la syphilis, nous avons regroupe les estimations nationales obtenues a l'aide de Spectrum-STI. Resultats Pour la chlamydiose, la gonorrhee et/ou la trichomonase, 130 etudes etaient eligibles. Pour la syphilis, la base de donnees de Spectrum-STI contenait 978 points de donnees pour la periode consideree. Les estimations de la prevalence mondiale en 2016 chez les femmes etaient les suivantes: chlamydiose 3,8% (intervalle d'incertitude de 95%, II: 3,3-4,5); gonorrhee 0,9% (II 95%: 0,7-1,1); trichomonase 5,3% (II 95%: 4,0-7,2); et syphilis 0,5% (II 95%: 0,4-0,6). Chez les hommes, les estimations de la prevalence etaient les suivantes: chlamydiose 2,7% (II 95%: 1,9-3,7); gonorrhee 0,7% (II 95%: 0,5-1,1); trichomonase 0,6% (II 95%: 0,4-0,9); et syphilis 0,5% (II 95%: 0,4-0,6). Lincidence totale estimee etait de 376,4 millions de cas: 127,2 millions (II 95%: 95,1-165,9 millions) de cas de chlamydiose; 86,9 millions (II 95%: 58,6-123,4 millions) de cas de gonorrhee; 156,0 millions (II 95%: 103,4-231,2 millions) de cas de trichomonase; et 6,3 millions (II 95%: 5,5-7,1 millions) de cas de syphilis. Conclusion Les estimations mondiales de la prevalence et de l'incidence de ces quatre infections sexuellement transmissibles guerissables restent elevees. Cette etude souligne la necessite d'amplifier les efforts de collecte de donnees au niveau des pays et offre un point de reference pour suivre la progression de la Strategie mondiale du secteur de la sante contre les 1ST2016-2021 de l'Organisation mondiale de la Sante. Objetivo Generar estimaciones de la prevalencia y la incidencia mundiales de la infeccion urogenital por clamidia, gonorrea, tricomoniasis y sifilis en mujeres y hombres de 15 a 49 anos de edad en 2016. Metodos Para la clamidia, la gonorrea y la tricomoniasis, se realizaron busquedas sistematicas de estudios realizados entre 2009 y 2016 que registrasen la prevalencia. Tambien se consulto a expertos regionales. Para generar estimaciones, se utilizo el metanalisis bayesiano. Para la sifilis, se anadieron las estimaciones nacionales generadas por el uso de Spectrum-STI. Resultados Para la clamidia, la gonorrea y/o la tricomoniasis, hubo 130 estudios que cumplian los criterios. Para la sifilis, la base de datos Spectrum-STI contenia 978 puntos de datos para el mismo periodo. Las estimaciones de prevalencia mundial en mujeres en 2016 fueron: clamidia 3,8 % (intervalo de incertidumbre, II, del 95 %: 3,3-4,5); gonorrea 0,9 % (II del 95 %: 0,7-1,1); tricomoniasis 5,3 % (II del 95 %: 4,0-7,2); y sifilis 0,5 % (II del 95 %: 0,4-0,6). Las estimaciones de prevalencia en hombres fueron: clamidia 2,7 % (intervalo de incertidumbre, II, del 95 %: 1,9-3,7); gonorrea 0,7 % (II del 95 %: 0,5-1,1); tricomoniasis 0,6 % (II del 95 %: 0,4-0,9); y sifilis 0,5 % (II del 95 %: 0,4-0,6). El total estimado de casos incidentes fue de 376,4 millones: 127,2 millones (II del 95 %: 95,1-165,9 millones) de casos de clamidia; 86,9 millones (II del 95 %: 58,6-123,4 millones) de casos de gonorrea; 156,0 millones (II del 95 %: 103,4-231,2 millones) de casos de tricomoniasis; y 6,3 millones (II del 95 %: 5,5-7,1 millones) de casos de sifilis. Conclusion Las estimaciones mundiales de la prevalencia y la incidencia de estas cuatro enfermedades de transmision sexual curables siguen siendo elevadas. El estudio destaca la necesidad de ampliar los esfuerzos de recopilacion de datos a nivel nacional y proporciona una base inicial para el seguimiento de los progresos de la Estrategia Mundial del Sector de la Salud de la Organizacion Mundial de la Salud sobre las ETS entre 2016 y 2021. [phrase omitted], Introduction Sexually transmitted infections are among the most common communicable conditions and affect the health and lives of people worldwide. The World Health Organization (WHO) periodically generates estimates to gauge [...]

`Sexually transmitted infections (STI) exact an astounding yet preventable toll on the health and lives of men and women worldwide. The World Health Organization (WHO) estimated 376 million new curable [...]

: Introduction: Sexually transmitted infections (STIs) remain prevalent and are increasing in several populations. Appropriate STI diagnosis is crucial to prevent the transmission and sequelae of untreated infection. We reviewed the diagnostic accuracy of syndromic case management and existing point‐of‐care tests (POCTs), including those in the pipeline, to diagnose STIs in resource‐constrained settings. Methods: We prioritized updating the systematic review and meta‐analysis of the diagnostic accuracy of vaginal discharge from 2001 to 2015 to include studies until 2018. We calculated the absolute effects of different vaginal flowcharts and the diagnostic performance of POCTs on important outcomes. We searched the peer‐reviewed literature for previously conducted systematic reviews and articles from 1990 to 2018 on the diagnostic accuracy of syndromic management of vaginal and urethral discharge, genital ulcer and anorectal infections. We conducted literature reviews from 2000 to 2018 on the existing POCTs and those in the pipeline. Results and discussions: The diagnostic accuracy of urethral discharge and genital ulcer disease syndromes is relatively adequate. Asymptomatic Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections limit the use of vaginal discharge and anorectal syndromes. The pooled diagnostic accuracy of vaginal syndromic case management for CT/NG is low, resulting in high numbers of overtreatment and missed treatment. The absolute effect of POCTs was reduced overtreatment and missed treatment. Findings of the reviews on syndromic case management underscored the need for low‐cost and accurate POCTs for the identification, first, of CT/NG, and, second, of Mycoplasma genitalium (MG) and Trichomonas vaginalis (TV) and NG and MG resistance/susceptibility testing. Near‐patient POCT molecular assays for CT/NG/TV are commercially available. The prices of these POCTs remain the barrier for uptake in resource‐constrained settings. This is driving the development of lower cost solutions. Conclusions: The WHO syndromic case management guidelines should be updated to raise the quality of STI management through the integration of laboratory tests. STI screening strategies are needed to address asymptomatic STIs. POCTs that are accurate, rapid, simple and affordable are urgently needed in resource‐constrained settings to support the uptake of aetiological diagnosis and treatment., Abbreviations Introduction Sexually transmitted infections (STIs) remain prevalent and a major burden of morbidity and mortality globally, impacting on quality of life, reproductive and child health, and national and individual [...]

During March 23, 2014-July 8, 2015, Guinea reported 3,748 Ebola virus disease (EVD) cases and 2,499 EVD-related deaths (1), as part of what is the largest reported EVD epidemic to [...]

Background Public health programs varied in ability to reach people with coronavirus disease 2019 (COVID-19) and their contacts to encourage separation from others. For both adult case patients with COVID-19 and their contacts, we estimated the impact of contact tracing activities on separation behaviors from January 2020 until March 2022. Methods We used a probability-based panel survey of a nationally representative sample to gather data for estimates and comparisons. Results An estimated 64 255 351 adults reported a positive severe acute respiratory syndrome coronavirus 2 test result; 79.6% isolated for ≥5 days, 60.2% isolated for ≥10 days, and 79.2% self-notified contacts. A total of, 24 057 139 (37.7%) completed a case investigation, and 46.2% of them reported contacts to health officials. More adults who completed a case investigation isolated than those who did not complete a case investigation (≥5 days, 82.6% vs 78.2%, respectively; ≥10 days, 69.8% vs 54.8%; both P <.05). A total of 84 946 636 adults were contacts of a COVID-19 case patient. Of these, 73.1% learned of their exposure directly from a case patient; 49.4% quarantined for ≥5 days, 18.7% quarantined for ≥14 days, and 13.5% completed a contact tracing call. More quarantined among those who completed a contact tracing call than among those who did not complete a tracing call (≥5 days, 61.2% vs 48.5%, respectively; ≥14 days, 25.2% vs 18.0%; both P <.05). Conclusions Engagement in contact tracing was positively correlated with isolation and quarantine. However, most adults with COVID-19 isolated and self-notified contacts regardless of whether the public health workforce was able to reach them. Identifying and reaching contacts was challenging and limited the ability to promote quarantining, and testing. [ABSTRACT FROM AUTHOR]