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      WHO global research priorities for sexually transmitted infections

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      , MD a , * , , MSN a , b , , Prof, PhD c , , MBBS d , , Prof, MD e , , MA a , b , , MD f , , PhD g , , BS a , , MD h , , PhD i , , Prof, MD j , , MPH k , , MD l , , Prof, MD m , , BS a , , MD b , , Prof, DrPH k , n , , PhD b , , Prof, MD o , , MD d , , Prof, PhD d , , Prof, PhD p , , PhD q , , MD r , , MD s , , Prof, PhD t , , PhD u , , MPH v , , Prof, PhD w , , Prof, PhD x , y , , MD b , , PhD a
      The Lancet. Global Health
      Elsevier Ltd

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          Summary

          Sexually transmitted infections (STIs) are widespread worldwide and negatively affect sexual and reproductive health. Gaps in evidence and in available tools have long hindered STI programmes and policies, particularly in resource-limited settings. In 2022, WHO initiated a research prioritisation process to identify the most important STI research areas to address the global public health need. Using an adapted Child Health and Nutrition Research Initiative methodology including two global stakeholder surveys, the process identified 40 priority STI research needs. The top priorities centred on developing and implementing affordable, feasible, rapid point-of-care STI diagnostic tests and new treatments, especially for gonorrhoea, chlamydia, and syphilis; designing new multipurpose prevention technologies and vaccines for STIs; and collecting improved STI epidemiologic data on both infection and disease outcomes. The priorities also included innovative programmatic approaches, such as new STI communication and partner management strategies. An additional six research areas related to mpox (formerly known as monkeypox) reflect the need for STI-related research during disease outbreaks where sexual transmission can have a key role. These STI research priorities provide a call to action for focus, investment, and innovation to address existing roadblocks in STI prevention, control, and management to advance sexual and reproductive health and wellbeing for all.

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          Digital technologies in the public-health response to COVID-19

          Digital technologies are being harnessed to support the public-health response to COVID-19 worldwide, including population surveillance, case identification, contact tracing and evaluation of interventions on the basis of mobility data and communication with the public. These rapid responses leverage billions of mobile phones, large online datasets, connected devices, relatively low-cost computing resources and advances in machine learning and natural language processing. This Review aims to capture the breadth of digital innovations for the public-health response to COVID-19 worldwide and their limitations, and barriers to their implementation, including legal, ethical and privacy barriers, as well as organizational and workforce barriers. The future of public health is likely to become increasingly digital, and we review the need for the alignment of international strategies for the regulation, evaluation and use of digital technologies to strengthen pandemic management, and future preparedness for COVID-19 and other infectious diseases.
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            Herpes simplex virus: global infection prevalence and incidence estimates, 2016

            Abstract Objective To generate global and regional estimates for the prevalence and incidence of herpes simplex virus (HSV) type 1 and type 2 infection for 2016. Methods To obtain data, we undertook a systematic review to identify studies up to August 2018. Adjustments were made to account for HSV test sensitivity and specificity. For each World Health Organization (WHO) region, we applied a constant incidence model to pooled prevalence by age and sex to estimate the prevalence and incidence of HSV types 1 and 2 infections. For HSV type 1, we apportioned infection by anatomical site using pooled estimates of the proportions that were oral and genital. Findings In 2016, an estimated 491.5 million people (95% uncertainty interval, UI: 430.4 million–610.6 million) were living with HSV type 2 infection, equivalent to 13.2% of the world’s population aged 15–49 years. An estimated 3752.0 million people (95% UI: 3555.5 million–3854.6 million) had HSV type 1 infection at any site, equivalent to a global prevalence of 66.6% in 0–49-year-olds. Differing patterns were observed by age, sex and geographical region, with HSV type 2 prevalence being highest among women and in the WHO African Region. Conclusion An estimated half a billion people had genital infection with HSV type 2 or type 1, and several billion had oral HSV type 1 infection. Millions of people may also be at higher risk of acquiring human immunodeficiency virus (HIV), particularly women in the WHO African Region who have the highest HSV type 2 prevalence and exposure to HIV.
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              Ebola RNA Persistence in Semen of Ebola Virus Disease Survivors - Preliminary Report.

              Background Ebola virus has been detected in the semen of men after their recovery from Ebola virus disease (EVD), but little information is available about its prevalence or the duration of its persistence. We report the initial findings of a pilot study involving survivors of EVD in Sierra Leone. Methods We enrolled a convenience sample of 100 male survivors of EVD in Sierra Leone, at different times after their recovery from EVD, and recorded self-reported information about sociodemographic characteristics, the EVD episode, and health status. Semen specimens obtained at baseline were tested by means of a quantitative reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay with the use of the target-gene sequences of NP and VP40. Results A total of 93 participants provided an initial semen specimen for analysis, of whom 46 (49%) had positive results on quantitative RT-PCR. Ebola virus RNA was detected in the semen of all 9 men who had a specimen obtained 2 to 3 months after the onset of EVD, in the semen of 26 of 40 (65%) who had a specimen obtained 4 to 6 months after onset, and in the semen of 11 of 43 (26%) who had a specimen obtained 7 to 9 months after onset; the results for 1 participant who had a specimen obtained at 10 months were indeterminate. The median cycle-threshold values (for which higher values indicate lower RNA levels) were 32.0 with the NP gene target and 31.1 with the VP40 gene target for specimens obtained at 2 to 3 months, 34.5 and 32.3, respectively, for specimens obtained at 4 to 6 months, and 37.0 and 35.6, respectively, for specimens obtained at 7 to 9 months. Conclusions These data showed the persistence of Ebola virus RNA in semen and declining persistence with increasing months since the onset of EVD. We do not yet have data on the extent to which positivity on RT-PCR is associated with virus infectivity. Although cases of suspected sexual transmission of Ebola have been reported, they are rare; hence the risk of sexual transmission of the Ebola virus is being investigated. (Funded by the World Health Organization and others.).
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                Author and article information

                Contributors
                Journal
                Lancet Glob Health
                Lancet Glob Health
                The Lancet. Global Health
                Elsevier Ltd
                2214-109X
                20 July 2024
                September 2024
                20 July 2024
                : 12
                : 9
                : e1544-e1551
                Affiliations
                [a ]Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland
                [b ]Global HIV, Hepatitis, and STIs Programmes, WHO, Geneva, Switzerland
                [c ]Weill Cornell Medicine–Qatar, Doha, Qatar
                [d ]WHO Regional Office for Africa, Brazzaville, Republic of the Congo
                [e ]Wake Forest University School of Medicine, Winston-Salem, NC, USA
                [f ]National Center for STD Control, Nanjing, China
                [g ]Institut Pasteur de Madagascar, Antananarivo, Madagascar
                [h ]Indian Council of Medical Research–National AIDS Research Institute, Pune, India
                [i ]Latin American Center for Perinatology, Women's and Reproductive Health, Pan American Health Organization, Montevideo, Uruguay
                [j ]All India Institute of Medical Sciences, New Delhi, India
                [k ]WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
                [l ]Kawasaki Settlement Clinic, CFMD, Tokyo, Japan
                [m ]University of Southern California, Los Angeles, CA, USA
                [n ]High Institute of Public Health, University of Alexandria, Alexandria, Egypt
                [o ]Universidade Federal do Espírito Santo, Ministério da Saúde, Brasilia, Brazil
                [p ]Melbourne Sexual Health Centre, Melbourne, VIC, Australia
                [q ]Foundation for Professional Development, East London, South Africa
                [r ]Pan American Health Organization, Washington, DC, USA
                [s ]WHO Regional Office for Europe, Copenhagen, Denmark
                [t ]Institute for Glycomics, Griffith University, Gold Coast, QLD, Australia
                [u ]WHO Regional Office for South-East Asia, New Delhi, India
                [v ]UNFPA, New York, NY, USA
                [w ]University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
                [x ]Imperial College School of Public Health, London, UK
                [y ]UK Health Security Agency, London, UK
                Author notes
                [* ]Correspondence to: Dr Sami L Gottlieb, Department of Sexual and Reproductive Health and Research, WHO, CH-1211 Geneva, Switzerland gottliebs@ 123456who.int
                Article
                S2214-109X(24)00266-3
                10.1016/S2214-109X(24)00266-3
                11342064
                39043199
                bf2efbe7-4a97-43fe-99ac-fe003f6950d2
                © 2024 World Health Organization

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).

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