New WHO Guidance on STI Testing and Diagnosis to Make Low-Cost POC Tests More Accessible

Every day, over one million individuals contract new sexually transmitted infections (STIs), marking a significant global health concern. The COVID-19 pandemic saw a dip in STI prevention, testing, and treatment services in numerous countries, resulting in a worldwide STI resurgence. Nations with robust STI surveillance like the US and UK have witnessed a rise in STIs. The emergence of infections such as mpox and the resurgence of neglected STIs challenge prevention and control efforts. There's growing concern over treatment-resistant strains of gonorrhea, particularly a Neisseria gonorrhea clone resistant to ceftriaxone, found in several countries. Diagnosing STIs in low- and middle-income countries is further complicated due to limited access to diagnostic tests.

To tackle these challenges, the World Health Organization (WHO, Geneva, Switzerland) has shared its latest guidance on sexually transmitted infections (STIs) at the STI & HIV 2023 World Congress which took place in Chicago, US, on 24-27 July 2023. Given the rising STI numbers, WHO has emphasized the need for improved testing and diagnostic services. During the congress, WHO shared its latest research on STIs and antibiotic resistance in gonorrhea. The new guidance includes target product profiles (TPPs) for point-of-care diagnostic technologies for diagnosing syphilis (treponema pallidum), Chlamydia trachomatis, Neisseria gonorrhea, and Trichomonas vaginalis, which intend to aid the development of quality STI diagnostics. TPPs can ensure that products are developed and produced to fulfill the clinical needs of populations at risk and are “fit-for-use” – in other words, that they are safe, effective, and adapted to the use environment. Point-of-care tests can reduce healthcare costs, minimize waiting times, expedite initiation of and enhance the accuracy of treatment, and improve patient follow-up.

The new fourth edition of the Laboratory and Point-of-Care Diagnostic Testing Guide for STIs, including HIV, offers the latest details on STI isolation, detection, and diagnosis. The guide has been expanded to include information about molecular testing, rapid on-the-spot tests, and diagnostic test quality management. A new product on the Diagnostics Landscape for Sexually Transmitted Infections (STIs) highlights diagnostics available to support scale-up of screening for syphilis, chlamydia, gonorrhea, trichomoniasis, mycoplasma, and human papillomavirus (HPV), specifically catering to the rising demand for tests in low-to-middle income countries.

“New models of STIs services need to be resilient and adaptive to current and future threats”, said Dr. Meg Doherty, Director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Infections Programs. “Recent scientific advances in STIs treatment and technologies, and innovative service delivery methods, provide an important opportunity to end STIs as a public health concern by 2030. However, large variations in investment, maturity and performance of STI surveillance systems between countries continues to be a challenge”.

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