对发达国家非妊娠青少年/成人衣原体和淋病筛查建议的现有指南进行环境扫描。
Environmental scan of available guidelines for chlamydia and gonorrhea screening recommendations for non-pregnant adolescents/adults in developed countries.
作者信息
Begum Housne, Basque Dominique, Haavaldsrud Michelle, Sullivan Holly, Gadient Stephan
机构信息
Public Health Agency of Canada, Ottawa, ON.
出版信息
Can Commun Dis Rep. 2025 Apr 3;51(4):119-128. doi: 10.14745/ccdr.v51i04a02. eCollection 2025 Apr.
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 and recommend universal screening for individuals <25 years of age.
背景
在过去十年中，加拿大报告的淋病和衣原体感染率稳步上升，淋病上升了171%，衣原体感染上升了26%。
目的
收集并综合国内外衣原体和淋病筛查指南，为修订加拿大公共卫生局（PHAC）当前的建议提供参考。
方法
对高收入国家已发表的衣原体和淋病筛查指南进行检索。使用《研究与评价指南评估II》（AGREE II）和PROGRESS-Plus工具对指南进行评估。
结果
本综述纳入了2015年至2023年间发表的17篇关于衣原体和淋病筛查的指南。AGREE II方法学评估的总体得分在7分制中为3至7分。只有一篇指南完全符合评估工具中确定的考量因素。大多数国际组织建议对衣原体进行普遍筛查，少数组织建议进行机会性筛查和针对性/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。国际淋病指南中没有一篇推荐机会性筛查。已证明普遍筛查对受检个体的负面影响最小，同时提高了检测率。大多数指南建议对25岁以下的个体进行筛查，而只有两个组织建议对30岁以下的个体进行筛查。
结论
本综述的结果将用于为修订PHAC当前关于衣原体和淋病筛查的建议提供参考，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。加拿大大多数省份和地区遵循PHAC的建议，建议对25岁以下的个体进行普遍筛查。
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