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Geneva, Switzerland, WHO, 2016.  p.Since the publication of the WHO Guidelines for the management of sexually transmitted infections in 2003, changes in the epidemiology of STIs and advancements in prevention, diagnosis and treatment necessitate changes in STI management. There is an urgent need to update treatment recommendations for gonococcal infections to respond to changing antimicrobial resistance (AMR) patterns of N. gonorrhoeae. High-level resistance to previously recommended quinolones is widespread and decreased susceptibility to the extended-spectrum (third-generation) cephalosporins, another recommended first-line treatment in the 2003 guidelines, is increasing and several countries have reported treatment failures. These guidelines for the treatment of common infections caused by N. gonorrhoeae form one of several modules of guidelines for specific STIs. It is strongly recommended that countries take updated global guidance into account as they establish standardized national protocols, adapting this guidance to the local epidemiological situation and antimicrobial susceptibility data. The objectives of these guidelines are: to provide evidence-based guidance on treatment of infection with N. gonorrhoeae; and to support countries to update their national guidelines for treatment of gonococcal infection.
Epidemic of sexually transmitted diseases in Eastern Europe. Report of a WHO meeting, Copenhagen, Denmark, 13-15 May 1996.
Copenhagen, Denmark, WHO, Regional Office for Europe, 1996. , 14 p. (EUR/ICP/CMDS 08 01 01)In response to the alarming rise in sexually transmitted diseases (STDs) in the newly independent states, the WHO Regional Office for Europe, WHO headquarters and the Joint United Nations Programme on AIDS organized a meeting of experts from the most affected countries to exchange information and to identify priority actions for the control of the epidemic. The participants included 15 experts from Belarus, Kazakhstan, Latvia, the Republic of Moldova, the Russian Federation and Ukraine. The participants called for urgent action, including a careful assessment of the existing systems for STD control, reallocation of resources among the various activity areas and strong advocacy to generate awareness at the top level of government and strengthen its support for the recommended initiatives. They also urged that national coordination of programmes to promote sexual health and prevent STDs and HIV be strengthened, that statutory services be made more accessible and acceptable to patients and that efforts be made to ensure that all health workers managing patients with STDs, including those in the private sector, provide high-quality care. (author's)
Advances in Reproduction. 2003; 7(4):217-219.Men suffer from a wide variety of STIs. Many of the more serious sexually transmitted infections infect men without causing any symptoms. Population based surveys relying only upon self-reported morbidity will miss the majority of infected men. Objective measures requiring laboratory validation are needed for sexually transmitted infection prevalence estimates. It is clinically easier and more effective to treat STI symptoms in men than in women. The predictive value of these symptoms in men is high: they are more likely to be due to a STI than to anything else. The picture in women is more problematic as endogenous, non-STIs are more common. Management of men with STI should always include treatment options for their sexual partners as well. Untreated STIs in man can lead to male infertility, acquisition and transmission of HIV, and STI transmission to female sexual partners, who may subsequently pass the infection to their unborn children. Not only is male-to-female STI transmission more efficient biologically, social and cultural factors often inhibit women's ability to protect themselves from infection. (author's)
Mission report, Regional Office, Manila. Subject: Sexually transmitted diseases surveillance system.
[Unpublished] 1992 Mar 3. , 29 p. (ICP/GPA/012; RS/91/0545)The objectives of this mission of the World Health Organization (WHO) were to establish a region-wide sexually transmitted diseases (STDs) surveillance system by integrating it into the AIDS/HIV infection surveillance system, to evaluate the regional STD program, and to provide STD consultation to other WHO disease prevention and control programs. The annual number of cases of gonorrhea, syphilis, and yaws were reported by 35 countries of the region from 1979 to 1990. China reported STDs only in 1990. In another 6 countries with populations between 10 and 150 millions only 2 countries filed adequate reports. In 6 countries with populations between 1 and 9 million also only 2 countries reported data regularly. 7 countries with adequate reporting were among 22 countries with less than 1 million of population. Vietnam had a major increase in reported gonorrhea and syphilis cases in 1990. In the Philippines the ratio of gonorrhea versus syphilis implied problems with the reporting of syphilis. The ratio of Guam was 4 times higher than expected. The short- and medium-term plan for AIDS contained detailed information on STDs. Findings indicated that: 1) Only gonorrhea and syphilis were reported regularly. Two-thirds of the countries did not report gonorrhea or syphilis with sufficient regularity to allow analysis of trends. 2) Underreporting was the major problem in several countries. 3) There were reporting errors. More systematic collection and feedback by the Regional Office on the Member States should ensure better reporting. Errors should be reduced by validating the information received and improving underreporting (sentinel surveillance and prevalence studies). The control and reporting of genital ulcer disease and syphilis should be strengthened because of evidence that they are risk factors for HIV-1 transmission. The evaluation of primary prevention of AIDS/HIV/STDs by the use of condoms and other measures should be improved. Information on the sex worker system and behavior is needed in most countries.
Approaching STDs and AIDS on a global scale. Interview with Peter Piot, Associate Director, Sexually Transmitted Diseases, Global Programme on AIDS (GPA), World Health Organisation (WHO).
AIDS BULLETIN. 1993 Jul; 2(2):4-5.Dr. Piot became involved with the World Health Organization (WHO) Global Program on AIDS (GPA) through his early involvement as Chairman of the WHO Steering Committee on the Epidemiology of AIDS. He responds to questions about the HIV pandemic. Although researchers realized early on that HIV could be transmitted sexually and suspected that condom use could confer protection against HIV infection as it does against other STDs such as gonorrhea and syphilis, only minimal light was shed to the public on the association of HIV with STDs. The delay in clearly pointing out the association stemmed from professionals' lack of desire to further stigmatize HIV/AIDS by designating it as a STD. Furthermore, many Western hematologists had little interest in STDs, and STD control in many countries tended to be coercive. Regarding the risk of HIV infection, Dr. Piot notes that the presence of a genital ulcer caused by syphilis, chancroid, or herpes increases one's risk 10-20-fold; risk increases 3- to 4-fold where gonorrhea or chlamydia are present. Acknowledging the association between STDs and the risk of contracting HIV and understanding the need to control STDs for the prevention of HIV/AIDS, the WHO's STD program was brought under the auspices of and integrated with the GPA. People, and especially women, who may present at STD clinics for treatment are prime candidates for much needed help in avoiding HIV infection; Dr. Piot notes that unlike men, many women do not realize they are infected with an STD until complications develop. Dr. Piot's recent appointment at GPA means the WHO will increase its focus upon the prevention and treatment of STDs. The WHO favors an integrated program approach. Additionally, the GPA plans to develop a short-list of recommended drugs for treating STDs and hopes to develop ways for developing countries to buy them affordably with help from UNICEF and the World Bank. Finally, Dr. Piot explains that, with some exceptions, the prevalence of STDs is lower in developed countries and, therefore, less of a prevention priority.