Environmental scan of available guidelines for chlamydia and gonorrhea screening recommendations for non-pregnant adolescents/adults in developed countries.

Housne Begum, Dominique Basque, Michelle Haavaldsrud, Holly Sullivan, Stephan Gadient
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Abstract

Background: Over the past ten years, there has been a steady increase in the reported rates of gonorrhea and chlamydia in Canada, with gonorrhea rising by 171% and chlamydia by 26%.

Objective: To collect and synthesize national and international chlamydia and gonorrhea screening guidelines to inform the revision of the current Public Health Agency of Canada (PHAC) recommendations.

Methods: A scan of published chlamydia and gonorrhea screening guidelines of high-income countries was conducted. Guidelines were appraised using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and PROGRESS-Plus tools.

Results: A total of 17 guidelines on chlamydia and gonorrhea screening published between 2015 and 2023 were included in this review. The overall score of the AGREE II methodological assessment ranged from a rating of three to seven out of seven points. Only one guideline fully met the considerations identified in the assessment tool. Most international organizations recommend universal screening for chlamydia, and a few organizations recommend opportunistic screening and targeted/risk-based screening. As for gonorrhea screening, organizations mostly recommend targeted/risk-based screening and a few organizations recommend universal screening. None of the international gonorrhea guidelines recommended opportunistic screening. The implementation of universal screening has been shown to have minimal negative impact on the individuals being screened, while increasing testing rates. Most guidelines recommend screening individuals <25 years of age, while only two organizations recommend screening individuals <30 years of age.

Conclusion: The findings of this review will be used to inform the revision of the current PHAC recommendations on chlamydia and gonorrhea screening, which will be published in early 2025. International organizations recommend either universal or opportunistic screening. The majority of Canadian provinces and territories follow PHAC's Sexually Transmitted and Blood-Borne Infections: Guides for Health Professionals and recommend universal screening for individuals <25 years of age.

发达国家未怀孕青少年/成人衣原体和淋病筛查建议现有指南的环境扫描。
背景:在过去十年中,加拿大报告的淋病和衣原体发病率稳步上升,淋病上升了171%,衣原体上升了26%。目的:收集和综合国家和国际衣原体和淋病筛查指南,为加拿大公共卫生署(PHAC)现行建议的修订提供信息。方法:对高收入国家出版的衣原体和淋病筛查指南进行扫描。使用研究与评估指南评估II (AGREE II)和PROGRESS-Plus工具对指南进行评估。结果:本综述共纳入了2015年至2023年间发表的17份衣原体和淋病筛查指南。AGREE II方法评估的总体得分范围从3到7分(满分7分)。只有一个指南完全满足评估工具中确定的考虑。大多数国际组织建议普遍筛查衣原体,少数组织建议机会性筛查和有针对性/基于风险的筛查。至于淋病筛查,各组织大多建议进行针对性/基于风险的筛查,少数组织建议进行普遍筛查。没有一项国际淋病指南建议进行机会性筛查。普遍筛查的实施已证明对接受筛查的个人产生的负面影响最小,同时提高了检测率。结论:本综述的发现将用于修订现行PHAC关于衣原体和淋病筛查的建议,该建议将于2025年初发布。国际组织建议进行普遍筛查或机会性筛查。加拿大大多数省和地区遵循PHAC的《性传播和血液传播感染:卫生专业人员指南》,并建议对个人进行普遍筛查
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