Clinical and Epidemiology Research and Development, GSK, Amsterdam, The Netherlands.
Clinical and Epidemiology Research and Development, GSK, Siena, Italy.
BMC Infect Dis. 2021 Nov 11;21(1):1152. doi: 10.1186/s12879-021-06381-4.
BACKGROUND: The World Health Organization (WHO) recommends periodic gonorrhoea prevalence assessments in the general population or proxies thereof (including pregnant women, women attending family planning clinics, military recruits, and men undergoing employment physicals for example) and in population groups at increased risk, including men-who-have-sex-with-men (MSM) and sex workers. METHOD: We evaluated reported prevalence data, including estimates from proxy general population samples to reflect the WHO recommendations. We describe the outcomes from the general population country-by-country and extend previous reviews to include MSM, sex workers, and extragenital infections. RESULT AND CONCLUSION: In our systematic search, 2015 titles were reviewed (January 2010-April 2019) and 174 full-text publications were included. National, population-based prevalence data were identified in only four countries (the United States of America, the United Kingdom, Peru, New Caledonia) and local population-based estimates were reported in areas within five countries (China, South Africa, Brazil, Benin, and Malawi). The remaining studies identified only reported test positivity from non-probability, proxy general population samples. Due to the diversity of the reviewed studies, detailed comparison across studies was not possible. In MSM, data were identified from 64 studies in 25 countries. Rectal infection rates were generally higher than urogenital or pharyngeal infection rates, where extragenital testing was conducted. Data on sex workers were identified from 41 studies in 23 countries; rates in female sex workers were high. Current prevalence monitoring was shown to be highly suboptimal worldwide. Serial prevalence monitoring of critical epidemiological variables, and guidelines to optimize prevalence study conduct and reporting beyond antenatal settings are recommended.
背景:世界卫生组织(WHO)建议定期对普通人群或其代表(包括孕妇、计划生育诊所就诊的妇女、新兵和接受就业体检的男性等)以及包括男男性行为者(MSM)和性工作者在内的高危人群进行淋病流行率评估。
方法:我们评估了报告的流行率数据,包括代表普通人群样本的估计值,以反映世卫组织的建议。我们按国家描述了普通人群的结果,并扩展了以前的综述,纳入了 MSM、性工作者和外生殖器感染。
结果与结论:在我们的系统检索中,共审查了 2015 年的标题(2010 年 1 月至 2019 年 4 月),并纳入了 174 篇全文出版物。仅在四个国家(美利坚合众国、联合王国、秘鲁、新喀里多尼亚)确定了国家、基于人群的流行率数据,在五个国家(中国、南非、巴西、贝宁和马拉维)的部分地区报告了当地基于人群的估计数据。其余研究仅报告了来自非概率、代表普通人群样本的检测阳性率。由于综述研究的多样性,无法对研究之间进行详细比较。在 MSM 中,从 25 个国家的 64 项研究中确定了数据。直肠感染率普遍高于泌尿生殖道或咽感染率,在进行外生殖器检测时。从 23 个国家的 41 项研究中确定了性工作者的数据;女性性工作者的比率很高。目前的流行率监测在全球范围内非常不理想。建议对关键流行病学变量进行连续流行率监测,并制定优化流行率研究实施和报告的指南,超出产前环境。
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