Proposal Session ISHCI 2018 

1a. Uses of rapid test technology for STI management and control of epidemics: Progress and evaluation 

Session proposed by:

1. Charlotte A. Gaydos: cgaydos@jhmi.edu

2. Syed Tariq Sadiq: ssadiq@sgul.ac.uk

 

Progress in the development of POC tests for STIs and antimicrobial resistance (chlamydia, gonorrhea, trichomonas, Mycoplasma genitalium HIV, syphilis) will be discussed. Recent advances in commercialization, FDA clearance and CE marking have allowed for implementation of rapid test to enable care pathways. When is a test good enough to fit end-users’ and stakeholders’ needs. What is the required time, sensitivity, specificity, cost, etc. required for uptake? What is the current evidence base for measurable benefit when using POC STI/AMR technologies and what are the major challenges to deployment. Where should the focus of application be for deployment? E.g. clinical, public health or both? With this in mind, a discussion of how the use of POC tests can address current epidemic STIs will cover strategies for implementation into standard of care where opportunities to shorten transmission exist, but where barriers and obstacles can prevent uptake. (i.e. how does a new POC test impact clinic flow, billing, cost, ability to treat before a patient leaves the clinic, and the necessity for confirmatory tests). What evidence will be required to identify the technical and implementation challenges for the use of future STI POC tests in pharmacy, home self-testing and other community and outreach settings in high and low middle income countries?

1b. Point-of-Care testing: progress toward, and consequences of, a diagnostic paradigm shift 

Session proposed by:

1. Barbara Van Der Pol: bvanderpol@uabmc.edu

 

This session will focus on the impact of point of care tests, and the imminent probability of self-tests, on chlamydia service provision. Consideration should be paid to ongoing assay development, and regulatory hurdles to commercialization, impact on patient outcomes, impact on clinical service utilization, impact on surveillance and control programs, and impact on sexual partner management.

2. Chlamydia trachomatis and STI testing in children: Medical-legal implications 

Session proposed by:

1. Margaret R Hammerschlag: mhammerschlag@downstate.edu

2. Peter Greenhouse: peter.greenhouse@uhbristol.nhs.uk

 

Testing for sexually transmitted infections (STIs) in children, including C. trachomatis, presents a number of problems for the practitioner that is not usually faced when testing adults. The identification of an STI in a child, in addition to medical implications, can have serious legal implications. The presence of an STI is often used to support the presence or allegations of sexual abuse and conversely, the identification of an STI in a child will prompt an investigation of possible abuse. The prevalence of C. trachomatis in children being evaluated for sexual abuse in most developed countries is low, <5%. Perinatal acquired infection of the vagina and rectum can persist for up to 3 years and can be a confounding variable. However, this is not an issue in countries where pregnant women are routinely screened and treated for C. trachomatis infection. Therefore it is important to use tests of the highest specificity and to retain the specimens for confirmatory testing. However, data on use of nucleic acid amplification tests for C. trachomatis in children, including use for extra-genital sites (pharynx and rectum) are limited. Another developing problem is the proliferation of unapproved (FDA and CE) assays for C. trachomatis. These assays have significant problems with both sensitivity and specificity. The major aim of this session will be to review currently available data on the epidemiology of C. trachomatis and other STIs in children begin evaluated for suspected sexual abuse and the current data on STI testing in this special population.

3. Methods and applications of chlamydia serology for public health 

Session proposed by:

1. Stephanie Migchelsen: Stephanie.Migchelsen@phe.gov.uk

2. Tim Waterboer: T.Waterboer@dkfz-heidelberg.de

 

Serologic tests for Chlamydia trachomatis (Ct) present promising options to improve understanding of Ct epidemiology and control. However, questions about their performance characteristics, comparability and interpretation remain. Ct serology and methods of analyzing serology data may offer means of investigating Ct prevalence, incidence, and disease, by time and place: this is an evolving area of research. This session will feature methods and applications of Ct serology for public health.

4. Chlamydia trachomatis: pregnancy and perinatal infection 

Session proposed by:

1. Margaret R. Hammerschlag: mhammerschlag@downstate.edu

2. Ingrid Rours: rours123@planet.nl

 

The rate of cervical infection with C. trachomatis during pregnancy varies from 1 to 37%, with the highest rates occurring in women 25 years of age and younger. The prevalence of C. trachomatis infection among pregnant women exceeds that of Neisseria gonorrhoeae even in developing countries, including Sudan, South Africa, Papua New Guinea and Brazil. Yet a minority of countries worldwide screen and treat pregnant women for this infection. Chlamydial infection during pregnancy has been associated with increased risk for ectopic pregnancy, spontaneous abortion, stillbirth, and preterm delivery. C. trachomatis infection can be acquired by the infant from the mother during parturition, as demonstrated in multiple well-controlled prospective studies conducted in the 1970s and 1980s of maternal–infant infection. The overall risk for an infant born to a mother with active chlamydial infection becoming infected at any anatomic site has been reported to be approximately 50 to 75% in various studies. Infants can be infected at more than one site, including the conjunctiva, nasopharynx, rectum, and vagina. The most frequent clinical manifestation of neonatal chlamydial infection, inclusion conjunctivitis, has been reported to occur in 15 to 37% of infants. Neonatal ocular prophylaxis is ineffective for prevention of neonatal chlamydial conjunctivitis and will not prevent respiratory infection.. The most effective method of control of perinatal C. trachomatis infection is screening and treatment of pregnant women. As rates of chlamydial infection among pregnant women exceed 20% in many populations in developing countries, which would make prenatal screening and treatment a very cost effective intervention. Furthermore, since programs can be rolled out into already existing antenatal care schedules.

5a. Reproductive Complications of Chlamydia trachomatis Infections 

Session proposed by:

1. Dr. Toni Darville: lad@email.unc.edu

2. Dr. Harold Wiesenfeld: hwiesenfeld@mail.magee.edu

 

Routine screening for C. trachomatis in young women can prevent the (sometimes silent) long-term reproductive complications of an untreated infection. This session will focus on sequelae of chlamydial infections, such as pelvic inflammatory disease, ectopic pregnancy, and infertility.

Abstract submissions should focus on sequelae, either from a clinical or epidemiological perspective, including the difficulties in diagnosing, and as a result monitoring, these conditions.

5b. Chlamydia and long-term reproductive tract complications in women. 

Session proposed by:

1. Prof Dr Nicola Low: nicola.low@ispm.unibe.ch

2. Prof Dr Jolande Land: j.land@maastrichtuniversity.nl

 

Genital chlamydia (Chlamydia trachomatis) control efforts aim to detect and treat current infections to prevent reproductive tract complications, particularly in women. Controlled trials and observational studies of screening programmes show that these interventions increase the number of individuals detected and treated and can reduce the incidence of pelvic inflammatory disease, but so far the prevalence of chlamydia has not been markedly reduced. The impact of chlamydia screening on complications of tubal pathology, including infertility and ectopic pregnancy is much harder to demonstrate because they are rare and often occur many years after the chlamydial infection. The incidence of such complications that is attributable to C. trachomatis infection is also difficult to measure directly. In this session researchers will be invited to present recent insights on this topic, based on patient-based and register-based cohort studies, surveillance data and modelling studies. New viewpoints about methods for evaluation and interpretation of research findings and implications for future strategies aimed at reducing the incidence of late complications from chlamydia will be discussed. Special attention will be paid to the potential value of targeting risk groups within the population that are most vulnerable or susceptible to the more severe sequelae from chlamydia infections.

5c. New Insights into the Reproductive Complications of C. trachomatis Genital Infections.  

 

Session proposed by:

1. Dr. Joseph Igietseme: jigietseme@cdc.gov

 

Although local inflammation is involved in the pathogenesis of the reproductive complications of C. trachomatis infections, the pathobiological processes that lead to fibrosis/scaring, epithelial dysfunction and infertility are not well understood.

Abstract submission for this session should focus on new molecular and biochemical mechanisms of complication development, including the induction of epithelial-mesenchyme transition (EMT), specific miRNA-mediated pathogenic processes, and secretion of extracellular matrix (ECM) components, among others.

6. Anal infections; treatment and public health control measures 

Session proposed by:

1.Nicole-Dukers-Muijrers: Nicole.dukers@ggdzl.nl

2.Christian Hoebe: Christian.hoebe@ggdzl.nl

3.Genevieve van Liere: Genevieve.vanliere@ggdzl.nl

4.Petra Wolffs: p.wolffs@mumc.nl

 

The proposed session would include presentations of new data on anal C. trachomatis (Ctr) and its clinical and public health impact. Studies are welcomed on clinical problems in anal Ctr management such as anal Ctr’s a) persistence after treatment, b) viability, and c) transmission (own body location/sexpartner), and on public health problems in anal Ctr control such as anal Ctr’s testing policies, treatment and partner-notification strategies. The session would be composed of presentations including a review/update on the topic, and recent new diagnostic and clinical data as well as epidemiological/behavioral data in humans relating to the transmission of Ctr via active anal sex, persistence of anal Ctr after treatment, and public health and clinical control measures needed.

7. The missing fecal/rectal reservoir hypothesis 

Session proposed by:

1.Patrik Bavoil: pbavoil@umaryland.edu

2.Henry de Vries: h.j.devries@amc.uva.nl

 

The proposed session would include presentations of new data in support of the hypothesis that a, C. trachomatis (Ctr) is a natural commensal organism of the GI track in humans that causes opportunistic infections at non-GI sites; b, Ctr colonizes one or multiple sites along the GI tract asymptomatically; c, Ctr is released in human feces from which it can contribute to the repeated transmission of infectious chlamydiae to the eyes of children with active trachoma via flies or fingers; d, Ctr survives the journey to the rectum from which it chronically or repeatedly contaminates/infects the lower genital tract, eventually contributing to reproductive sequelae in women. The session would be composed of presentations including a review/update of the hypothesis, and recent data from animals as well as epidemiological/behavioral data in humans relating to the acquisition of Ctr via active oral sex (women and MSM) or via direct contact (children with active trachoma).

8. Future perspectives in Chlamydia control 

Session proposed by:

1. Jane Hocking:j.hocking@unimelb.edu.au

2. Otilia Mardh:Otilia.Mardh@ecdc.europa.eu

3. Birgit van Benthem:birgit.van.benthem@rivm.nl

 

Chlamydia (Chlamydia trachomatis) transmission is difficult to control on the population level. Despite all the efforts in testing and treating infections in national screening programmes, targeted testing or opportunistic testing strategies, the prevalence of Chlamydia appears to remain stable in many countries. What might be reasons for this? And what are the new viewpoints regarding future strategies aiming at the control of chlamydia? What are the new points of view and developments regarding partner notification and partner treatment? Should we focus more on repeated testing? Should we stop testing and treatment for Chlamydia and focus our attention towards preventing infections? Which (new) insights are needed to determine the future course of Chlamydia control?

9. Animal and environmental chlamydioses: Zoonotic implications in a One Health perspective 

Session proposed by:

1. Yvonne Pannekoek: y.pannekoek@amc.uva.nl

2. Nicole Borel: n.borel@access.uzh.ch

 

The order Chlamydiales harbours members known for their relevance as human, animal and environmental pathogens while the zoonotic implications of novel members in several families of the order are largely unknown. Within the Chlamydiaceae, the recent observation of zoonotic Chlamydia caviae presenting as severe community-acquired pneumonia and the detection of Chlamydia suis in humans exemplify the emergence of new risks and point to novel virulence properties for these microorganisms. In addition, the recent discovery of two new species (Chlamydia gallinacea and Chlamydia avium) in poultry and other birds but also in cattle, the identification of novel Chlamydia abortus strains as zoonotic and abortive species in cattle and small ruminants, the emerging role of Chlamydia psittaci in equine abortion, and the growing list of new “environmental” species outside the Chlamydiaceae, suggest that many chlamydial species are not restricted to one particular host. Thus, the diversity and host range of known and novel species are expanding as well as their zoonotic potential. In this session, we will highlight recent developments in the field of animal and environmental chlamydioses and encourage investigators to submit molecular, epidemiological and clinical data from these infections that highlight the zoonotic potential of Chlamydiaceae. Our aim is to facilitate a “One Health” network between public health, environmental and veterinary professionals.

PROGRAMME

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IMPORTANT DATES

Session suggestion deadline: 10 November 2017

 

Submission opens: 20 November 2017

 

Abstract deadline: 22 January 2018

 

Abstract notification: 1 March 2018

 

Registration deadline: 1 March - 5 April 2018

(incl. early registration)

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