CDC Recommendations for the Laboratory-Based Detection of Chlamydia trachomatis and Neisseria gonorrhoeae - 2014
This report updates CDC’s 2002 recommendations regarding screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections and provides new recommendations regarding optimal specimen types, the use of tests to detect rectal and oropharyngeal C. trachomatis and N. gonorrhoeae infections, and circumstances when supplemental testing is indicated. The recommendations in this report are intended for use by clinical laboratory directors, laboratory staff, clinicians, and disease control personnel who must choose among the multiple available tests, establish standard operating procedures for collecting and processing specimens, interpret test results for laboratory reporting, and counsel and treat patients.
CDC Fact Sheet: Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the United States
In February 2013, CDC published two analyses that provide an in-depth look at the severe human and economic burden of sexually transmitted infections (STIs) in the United States. CDC's new estimates show that there are about 20 million new infections in the United States each year, costing the American healthcare system nearly $16 billion in direct medical costs alone.
America's youth shoulder a substantial burden of these infections. CDC estimates that half of all new STIs in the country occur among young men and women. CDC's new data suggest that there are more than 110 million total STIs among men and women across the nation.
CDC's analyses included eith common STIs: chlamydia, gonorrhea, heapatitis B virus (HBV), herpes simplex virus type 2 (HSV-2), human immunodeficiency virus (HIV), human papillomavirus (HPV), syphilis, and trichomoniasis.
CDC Fact Sheet: STD Trends in the United States (2011 National Data for Chlamydia, Gonorrhea, and Syphilis)
This fact sheet summarizes 2011 data on chlamydia, gonorrhea, and syphilis published in CDC's annual report, Sexually Transmitted Diseases Surveillance, 2011 (available at www.cdc.gov/std/stats). The data are based on state and local STD case reports from a variety of private and public sources which indicate that the majority of cases are seen in non-STD clinic settings, such as private physician offices and health maintenance organizations.
Many cases of chlamydia, gonorrhea, and syphilis continue to go undiagnosed and unreported, and data on several addtional STDs (such as human papillomavirus, herpes simplex virus, and trichomoniasis) are not routinely reported to CDC. As a result, the annual surveillance report captures only a fraction of the true burden of STDs in America. However, it provides important insights into the scope and trends of this hidden edpidemic.
Bringing the Lab to the Patient: Developing Point-of-Care Diagnostics for Resource Limited Settings
Easy-to-use, inexpensive point-of-care tests (POCTs) to diagnose infectious diseases are urgently needed in resource-limited settings where laboratory capacity is limited. Development and implementation of new POCTs requires coordinated efforts among the scientists and engineers designing the tests and the health care workers deploying them. Recognizing the need to connect theses groups, the American Academy of Microbiology convened a colloquium in September 2011 to discuss how to develop POCTs that can be effectively integrated into resource limited settings.
Based on that colloquium, this report identifies the POCTs that would make the biggest impact on health and the qualities they need to be effective in resource limited settings. The report also discusses systemic barriers to POCT deployment and recommends addressing these barriers in order to foster a more conducive environment for POCT development. The report is an example of the benefit of improved communication among the many groups that must work together to bring POCTs to the people that need them most.
The Sexually Transmitted Diseases Treatment Guidelines-2010 were published in the Centers for Disease Control and Prevention's (CDC) December 17, 2010 issue of Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports. The 2010 Guidelines serve as a source of clinical guidance and advise health care providers on the most effective treatment regimens, screening procedures, and prevention and vaccination strategies for STDs. The Guidelines are revised approximately every three to four years and are based on newly available evidence.
A print version of the 2010 Guidelines may be viewed or downloaded from the CDC website at http://www.cdc.gov/std/treatment/2010/.
The National Chlamydia Coalition (NCC) Research Committee has released a series of Research Briefs:
Developments in STD Screening: Chlamydia Testing discusses current methods of diagnostic and testing methods; preferred specimens; new specimen types, such as urine and vaginal swabs; rectal and pharyngeal specimens; and alternative venues for screening. The Research Brief may be viewed here as a pdf.
Laboratory Considerations for Male Chlamydia Screening describes and reviews the methods for laboratory diagnosis of Chlamydia trachomatis in men. There are no formal recommendations by professional organizations for screening men for chlamydia, however, guidance has been provided by the Centers for Disease Control and Prevention for clinical sites wishing to screen men. The Research Brief may be viewed here as a pdf.
Getting More Young Women Screened for Chlamydia: Findings from Qualitative Research provides valuable insights into why women do or do not seek chlamydia screening and helps us understand the key factors influencing a woman's decision to get tested, including attitudes, knowledge, beliefs, perceived social norms, and skills. The Research Brief may be viewed here as a pdf.
Developing Effective Strategies for Increasing Patient Retesting Rates (April 2012) discusses how low retesting rates are often a result of low patient return rates as well as missed opportunities for retesting patients who return to the medical office for other reasons. The Expert Commentary may be viewed here as a pdf.
The NCC introduced a new feature in June of 2012 - Hot Topic - an updated version of the Research Translation Committee's Research Brief:
Cost Effectiveness of Chlamydia Screening (June 2012) discusses how increasing chlamydia screening coverage of women could be a cost-effective way to improve women's health and reduce the burden of chlamydia in the population. The Research Brief may be viewed here as a pdf.
Extra-Genital Chlamydia and Gonorrhea Infections (August 2012) discusses the testing of extra-genital sites for chlamydia and gonorrhea, especially within the high risk men-who-have-sex-with men (MSM) community. The Research Brief may be viewed here as a pdf.
Comparative Effectiveness of POC Tests for Chlamydia in a Clinic Setting (September 2012) shows that promising new chlamydia point-of-care tests are likely to be cost-effective compared with traditional nucleic acid amplification tests in a clinic when specified characteristics are met. The Expert Commentary (by Charlotte Gaydos, MS, MPH, DrPH) may be viewed here as a pdf.
Practical Strategies for Improving Chlamydia and Gonorrhea Retesting (October 2012) discusses how prevention and management of chlamydial and gonococcal infections are priorities for women's health. The Centers for Disease Control and Prevention (CDC) highlights the prevention and early detection of repeat infections in females as a key strategy to avert STD-related infertility. The Expert Commentary may be viewed here as a pdf.
Many with Chlamydia Fail to Receive Recommended Retest (February 2013) discusses how interventions, both for providers and for patients, need to be developed, piloted, and implemented to increase adherence to CDC recommendations for chlamydia testing, retesting, and partner treatment. The Expert Commentary may be viewed here as a pdf.
New Estimates on Health and Economic Burden of STIs (March 2013) discusses the ongoing severe health and economic toll of sexually transmitted infections in the United States, and demonstrates an urgent need for prevention especially among young men and women. The Expert Commentary may be viewed here as a pdf.
New Rapid Real-Time Assay for Chlamydia & Gonorrhea Screening (April 2013) discusses the Cepheid® GeneXpert CT/NG assay, FDA cleared in December 2012, that demonstrates excellent sensitivity and specificity, and could guide treatment decisions which may significantly improve chlamydia and gonorrhea control efforts. The Expert Commentary (by Charlotte Gaydos, MS, MPH, DrPH) may be viewed here as a pdf.
Research Suggests Family Planning Clinics Should Screen Males for Chlamydia (July 2013) discusses the need for cost-effectiveness studies assessing the potential benefits of screening men for chlamydia in Family Planning settings, where prevalence is much higher that 5%, may be viewed here as a pdf.
STD Surveillance 2012: Focus on Chlamydia (March 2014) discusses the statistics and trends for Chlamydia trachomatis as presented in the annual report by the Division of STD Prevention at CDC. The Expert Commentary (by Charlotte Gaydos, MS, MPH, DrPH) may be viewed here as a pdf.
Sexually transmitted diseases (STDs) remain a major public health challenge in the U.S., especially among women, who disproportionately bear the long-term consequences of STDs.
For example, each year untreated STDs cause infertility in at least 24,000 women in the U.S., and untreated syphilis in pregnant women results in infant death in up to 40% of cases. Testing and treatment are keys to reducing disease and infertility associated with undiagnosed STDs.
Why are women so severely affected by STDs? Here are 10 ways STDs impact women differently from men.
Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, and are interrelated and preventable.
The Youth Risk Behavior Surveillance System (YRBSS) monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, including - - 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity.
In addition, YRBSS monitors the prevalence of obesity and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. This report summarizes results from the 2011 national survey, 43 state surveys, and 21 large urban school district surveys conducted among students in grades 9–12.
Youth Risk Behavior Surveillance - United States 2011 can be found on the CDC website.