Future chlamydia screening preferences of men attending a sexually transmissible infection clinic

Sexual Health ◽  
2011 ◽  
Vol 8 (3) ◽  
pp. 419 ◽  
Author(s):  
Alexis Roth ◽  
Barbara Van Der Pol ◽  
Brian Dodge ◽  
J. Dennis Fortenberry ◽  
Gregory Zimet

Background Despite years of public health efforts, Chlamydia trachomatis remains a highly prevalent disease suggesting that current control strategies are not sufficient. Asymptomatic men with chlamydial infections are under-identified and probably play an important role in sustaining the epidemic. Novel methods of actively screening asymptomatic men are needed to reduce the prevalence of chlamydia. This formative study explored the features of a sexually transmissible infection (STI) control program that would encourage annual testing among men. Methods: Using semi-structured interviews and focus group discussions, we explored issues related to health seeking behaviours and preferences for STI screening among men recruited from a public health STI clinic. Results: All 29 participants acknowledged the expertise of clinic staff and most men preferred speaking with a provider over using electronic informational resources. The clinic was the preferred venue for future screening, followed by self-collected home sampling with clinic drop-off. Men expressed a preference for receiving results via the telephone rather than electronic options, and preferred personalised reminders for future STI screening. Conclusions: In this sample, there was high interest in utilising the expertise of STI clinic personnel and less in non-clinical options. While this may be due to recruiting from an STI clinic, the data serves as a reminder that service provision must be responsive to the needs of potential users. Our findings suggest that future non-clinic based screening strategies may require an initial educational component to address concerns about confidentiality and sample quality in order to be acceptable.


Sexual Health ◽  
2014 ◽  
Vol 11 (3) ◽  
pp. 217 ◽  
Author(s):  
David J. Templeton ◽  
Phillip Read ◽  
Rajesh Varma ◽  
Christopher Bourne

Men who have sex with men (MSM) in Australia and overseas are disproportionately affected by sexually transmissible infections (STIs), including HIV. Many STIs are asymptomatic, so regular testing and management of asymptomatic MSM remains an important component of effective control. We reviewed articles from January 2009–May 2013 to inform the 2014 update of the 2010 Australian testing guidelines for asymptomatic MSM. Key changes include: a recommendation for pharyngeal chlamydia (Chlamydia trachomatis) testing, use of nucleic acid amplification tests alone for gonorrhoea (Neisseria gonorrhoeae) testing (without gonococcal culture), more frequent (up to four times a year) gonorrhoea and chlamydia testing in sexually active HIV-positive MSM, time required since last void for chlamydia first-void urine collection specified at 20 min, urethral meatal swab as an alternative to first-void urine for urethral chlamydia testing, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.



Sexual Health ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. 120 ◽  
Author(s):  
Myles Balfe ◽  
Ruairi Brugha ◽  
Emer O'Connell ◽  
Deirdre Vaughan ◽  
Diarmuid O'Donovan

Objectives Chlamydia trachomatis is a sexually transmissible infection (STI) that affects significant numbers of men. Research on men’s perspectives on chlamydia screening (or testing) has been limited. We conducted a narrative review to examine: (1) what factors encourage or discourage men from attending health services for chlamydia screening, and/or from accepting screening once it has been offered to them, and (2) where men want chlamydia screening services to be located. Methods: A narrative review of the recent peer-reviewed literature (published between 1999 and 2009) on men’s attitudes towards chlamydia screening. To be included, articles had to explore men’s perspectives on screening (which could be ascertained through quantitative or qualitative studies, or from relevant discussion papers or reviews). Results: Forty-eight articles were included in all. Men’s attitudes towards chlamydia screening are influenced by their knowledge about the infection, their perceived vulnerability to the infection, the degree of embarrassment and shame that they associate with screening and the stigma that they associate with screening. Men prefer to be offered urine testing for chlamydia. Men want to be offered screening by non-judgemental professionals. Men’s attitudes towards screening for chlamydia in general practice, genito-urinary medicine clinics, home and outreach settings are also explored in this review. Conclusions: Several factors influence men’s attitudes towards screening. Two central themes underlie and influence many of these factors: men’s needs to make positive impressions on others, and men’s identification with particular ideals of masculinity. The review concludes with suggestions for future research on this topic.



Sexual Health ◽  
2013 ◽  
Vol 10 (3) ◽  
pp. 229 ◽  
Author(s):  
Sajni Gudka ◽  
Folasade E. Afuwape ◽  
Bessie Wong ◽  
Xuan Li Yow ◽  
Claire Anderson ◽  
...  

Background Chlamydia (Chlamydia trachomatis) is the most commonly notified sexually transmissible infection in Australia. Increasing the number of people aged 16–25 years being tested for chlamydia has become a key objective. The strategy recommends that chlamydia screening sites should be easy to access. Community pharmacies are conveniently located and easily accessible. This review aimed to determine the different types of pharmacy-based chlamydia screening interventions, describe their uptake rates, and understand issues around the acceptability of and barriers to testing. Methods: Seven electronic databases were searched for peer-reviewed articles published up to 30 October 2011 for studies that reported chlamydia screening interventions from community pharmacies, or had qualitative evidence on acceptability or barriers linked with interventions. Results: Of the 163 publications identified, 12 met the inclusion criteria. Nine reported chlamydia screening interventions in a pharmacy setting, whereas three focussed on perspectives on chlamydia screening. Pharmacists could offer a chlamydia test to consumers attending the pharmacy for a sexual health-related consultation, or consumers could request a chlamydia test as part of a population-based intervention. Participating consumers said pharmacies were accessible and convenient, and pharmacists were competent when offering a chlamydia test. Pharmacists reported selectively offering tests to women they thought would be most at risk, undermining the principles of opportunistic interventions. Conclusion: Chlamydia screening from community pharmacies is feasible, and can provide an accessible, convenient venue to get a test. Professional implementation support, alongside resources, education and training programs, and incentives may overcome the issue of pharmacists selectively offering the test.



2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
Jesus GAS ◽  
M R Silva ◽  
M L Miranda ◽  
I M Reis

Abstract Tuberculosis is an important public health problem of global magnitude. Although it has had diagnostic and therapeutic support for decades, its control requires attention in several points from the health system. In this context, epidemiological and operational indicators allow evaluating the effectiveness of the Tuberculosis Control Program. A retrospective epidemiological study was conducted with a quantitative approach, referring to the period from 2014 to 2018, in the township of Ilhéus, using secondary data from the Information System of Notifiable Diseases of the State Secretariate of Bahia (SINAN/SESAB). During the analyzed period, 678 cases of tuberculosis were identified in the information system, with an average annual incidence coefficient of 71.32 cases/100,000 inhabitants and a mortality coefficient with an average of 4.45 deaths/100,000 inhabitants. The test rate of these HIV patients was 56.64%. Regarding the directly observed treatment (DOT), the annual average was 10.19% cases that underwent this follow-up, with a reduction of 28.57% of cases in 2014 followed up with DOT for only 8.11% of cases in 2018. Regarding the closure situation, in 2018 there was a higher proportion of individuals who presented cure (77.61%), lower proportion of treatment abandonment (18.30%), as well as a lower number of cases with closure due to death (2.99%). Thus, it is perceived that tuberculosis in the township of Ilhéus presents values far from what is recommended and remains an important public health problem. In view of this scenario, highlights the importance of decentralization of the service, with its management guided by the evaluation of indicators and the consolidation of primary health care. Key messages This study is relevant because it allows the assessment of the tuberculosis profile. The analysis of the indicators makes it possible to adopt appropriate prevention and control strategies.



2006 ◽  
Vol 48 (3) ◽  
pp. 151-156 ◽  
Author(s):  
Filipe Dantas-Torres ◽  
Sinval Pinto Brandão-Filho

In the last 20 years, despite the known underestimation of cases, Brazil registered a marked increase in the incidence of visceral leishmaniasis. The main goal of this review is to reflect on some aspects of this zoonosis in Brazil and also to encourage the discussion in order to find more viable, effective and affordable strategies to be implemented by the Brazilian Leishmaniasis Control Program. The current situation of visceral leishmaniasis in Brazil might be seen as a paradox: the most important aspects of the disease are known, but so far the control of this disease has not yet been achieved. The current control strategies have not been able to prevent the geographical expansion, and even a rise in the incidence and lethality of visceral leishmaniasis. There is a need not only for a better definition of priority areas, but also for the implementation of a fieldwork monitoring system to the disease surveillance that could permit a further evaluation of the control program in areas where visceral leishmaniasis is endemic.



Sexual Health ◽  
2007 ◽  
Vol 4 (1) ◽  
pp. 45 ◽  
Author(s):  
Shayna D. Cunningham ◽  
Todd Meyers ◽  
Deanna Kerrigan ◽  
Jonathan M. Ellen

Background: Individuals diagnosed with a sexually transmissible infection (STI) often face psychosocial concerns through which they must navigate to arrive at disclosure decisions. The objective of this study was to qualitatively explore the decision-making process for disclosure of STI diagnoses to sex partners among adolescent females in Baltimore City, MD. Methods: Semi-structured interviews were conducted with 21 African American adolescent females who tested positive for chlamydia and/or gonorrhoea in the previous 3 months. Three individuals also provided audio diaries in which they tape recorded a daily journal discussing their lives and experiences with STIs. Results: Female adolescents often do not notify all potentially infected sex partners or tell sex partners all of the STIs to which they may have been exposed. Although participants recognised the importance of informing their sex partner(s) of their STI diagnosis, there were other competing psychosocial factors that influenced their decisions to disclose, such as perceptions of the social consequences of having an STI including fear of stigmatisation and loss of relationship. Such concerns appear to vary by disease and partner type as well as previous STI experience. Conclusions: To increase disclosure of STI diagnoses, clinic counselling strategies to encourage partner notification should seek to engage patients in a dialogue regarding their fears related to their diagnoses, how this might affect their relationships with different types of partners and the individual and social meanings their specific STI diagnosis(es) might hold.



Sexual Health ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 96
Author(s):  
David J. Templeton ◽  
Phillipe C. G. Adam ◽  
Rajesh Varma ◽  
Phillip Read ◽  
Chistopher Bourne ◽  
...  

The Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men were updated in 2014. An evaluation study targeting Sydney-based general practitioners was conducted among 85 clinicians. Respondents with knowledge of guideline recommendations were significantly more likely to feel comfortable asking men who have sex with men about their sexual history (98.1% vs 81.3%, P = 0.039), and to recommend at least annual testing (94.0% vs 68.8%, P = 0.015), 3-month retesting after chlamydia or gonorrhoea treatment (96.2% vs 73.3%, P = 0.017) and syphilis testing with routine HIV monitoring bloods (90.2% vs 57.1%, P = 0.037). Familiarity with the guidelines was associated with a range of positive outcomes on general practitioners’ clinical practice. Novel approaches are required to ensure more widespread distribution of future guidelines.



2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.



Insects ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 146
Author(s):  
Jordan Hoffman ◽  
Ilinca Ciubotariu ◽  
Limonty Simubali ◽  
Twig Mudenda ◽  
William Moss ◽  
...  

Despite dramatic reductions in malaria cases in the catchment area of Macha Hospital, Choma District, Southern Province in Zambia, prevalence has remained near 1–2% by RDT for the past several years. To investigate residual malaria transmission in the area, this study focuses on the relative abundance, foraging behavior, and phylogenetic relationships of Anopheles squamosus specimens. In 2011, higher than expected rates of anthropophily were observed among “zoophilic” An. squamosus, a species that had sporadically been found to contain Plasmodium falciparum sporozoites. The importance of An. squamosus in the region was reaffirmed in 2016 when P. falciparum sporozoites were detected in numerous An. squamosus specimens. This study analyzed Centers for Disease Control (CDC) light trap collections of adult mosquitoes from two collection schemes: one performed as part of a reactive-test-and-treat program and the second performed along a geographical transect. Morphological identification, molecular verification of anopheline species, and blood meal source were determined on individual samples. Data from these collections supported earlier studies demonstrating An. squamosus to be primarily exophagic and zoophilic, allowing them to evade current control measures. The phylogenetic relationships generated from the specimens in this study illustrate the existence of well supported clade structure among An. squamosus specimens, which further emphasizes the importance of molecular identification of vectors. The primarily exophagic behavior of An. squamosus in these collections also highlights that indoor vector control strategies will not be sufficient for elimination of malaria in southern Zambia.



2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Manjulaa Narasimhan ◽  
Carmen H. Logie ◽  
Kevin Moody ◽  
Jonathan Hopkins ◽  
Oswaldo Montoya ◽  
...  

Abstract Background Self-care interventions are influencing people’s access to, expectation and understanding of healthcare beyond formal health delivery systems. In doing so, self-care interventions could potentially improve health-seeking behaviours. While many men proactively engage in maintaining and promoting their health, the focus on men’s health comes from the recognition, at least partially, that male socialization and social norms can induce men and boys to have a lower engagement in institutionalized public health entities and systems around their sexual and reproductive health and rights, that could impact negatively on themselves, their partners and children. Main text A research agenda could consider the ways that public health messaging and information on self care practices for sexual and reproductive health and rights could be tailored to reflect men’s lived realities and experiences. Three examples of evidence-based self-care interventions related to sexual and reproductive health and rights that men can, and many do, engage in are briefly discussed: condom use, HIV self-testing and use of telemedicine and digital platforms for sexual health. We apply four core elements that contribute to health, including men’s health (people-centred approaches, quality health systems, a safe and supportive enabling environment, and behaviour-change communication) to each intervention where further research can inform normative guidance. Conclusion Engaging men and boys and facilitating their participation in self care can be an important policy intervention to advance global sexual and reproductive health and rights goals. The longstanding model of men neglecting or even sabotaging their wellbeing needs to be replaced by healthier lifestyles, which requires understanding how factors related to social support, social norms, power, academic performance or employability conditions, among others, influence men’s engagement with health services and with their own self care practices.



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