School-Based STD Screening

A special issue of Biology (ISSN 2079-7737). This special issue belongs to the section "Infection Biology".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 3889

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Guest Editor
Department of Medicine, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
Interests: adolescent health; epidemiology; infectious diseases; public health; sexually transmitted diseases; sexually transmitted infections; statistical methods; women's health
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Special Issue Information

Statement of Purpose

The last three decades have seen the development of highly sensitive and specific nucleic acid amplification technology for the detection of sexually transmitted microorganisms. This development resulted in improvements in the screening coverage and reporting of Chlamydia trachomatis and Neisseria gonorrhea, the causative agents of the most common bacterial sexually transmitted infections in most developed countries, with long-term complications that strain countries’ healthcare costs.

In the United States, widespread screenings for chlamydia and gonorrhea were implemented in school settings since 1995 to reach adolescents where they can be found. Substantial amount of data have been collected that can enhance our understanding of the epidemiology and control of sexually transmitted infections in this high-risk population.

In the summer of 2014, the Division of Adolescent and School Health and the Division of STD Prevention of the United States Centers for Disease Control and Prevention convened a School-Based STD Screening panel of experts, the purpose of which was to assist the Division of Adolescent and School Health in developing a greater understanding of school-based STD screening programs. The panel noted that, for various reasons, including programs’ lack of capacity to publish, more chlamydia and gonorrhea screening activities are conducted in schools than are documented in the published literature.

However, the principles of screening for disease that are applied to screen students for chlamydia and gonorrhea in schools were developed with the acknowledgement that the data that would be amassed during screening activities would be subjected to statistical analysis that could uncover important trends, and new knowledge would be accumulated that could advance medical science and practice.

Scope

This Special Issue encourages the submission of manuscripts on school-based STD screening data, including but not limited to the prevalence and incidence of sexually transmitted infections in schools; notification of test results to participants and treatment coverage for infected students; strategies for contact tracing, notification and treatment; behavioral characteristics of participants in school-based STD screenings; and costs of conducting STD screenings in schools. Mathematical modelling studies of data obtained in school-based STD screening programs would also be considered. Manuscripts based on data obtained on adolescents and young adults screened outside of school settings that the Authors think have implications for school-based STD screening are also welcomed. Original research manuscripts are encouraged. To a lesser degree, review articles could be considered.

Dear Colleagues,

In the summer of 2014, the Division of Adolescent and School Health and the Division of STD Prevention of the United States Centers for Disease Control and Prevention convened a School-Based STD Screening panel of experts, the purpose of which was to assist the Division of Adolescent and School Health in developing a greater understanding of school-based STD screening programs. The panel noted that more chlamydia and gonorrhea screening activities are conducted in schools than are documented in the published literature.

This Special Issue encourages submission of manuscripts on school-based STD screening data, including but not limited to the prevalence and incidence of sexually transmitted infections in schools; the notification of test results to participants and treatment coverage for infected students; strategies for contact tracing, notification and treatment; behavioral characteristics of participants in school-based STD screenings; costs of conducting STD screenings in schools. Mathematical modelling studies of data obtained in school-based STD screening programs would also be considered. Original research manuscripts are encouraged. To a lesser degree, review articles could be considered.

Widespread screenings for chlamydia and gonorrhea have been implemented in school settings in the United States since 1995, and screening activities were also conducted in schools in other countries around the world. However, the existing literature does not reflect the fact that there have been 25 years of annually obtaining information on school-based STD screenings that can enhance our understanding of STIs among adolescents. This Special Issue should supplement and fill the obvious gap that exist between the massive amount of data that have been accumulated during 25 years of on-going school-based STD screenings and the apparent paucity of related reports in the published literature. Submissions from countries other than the United States are highly encouraged.

Dr. M. Jacques Nsuami
Guest Editor

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Keywords

  • adolescents;
  • bacterial infections;
  • behavior;
  • epidemiology;
  • health costs;
  • incidence;
  • mathematical modelling;
  • prevalence;
  • school health;
  • screening;
  • sexually transmitted diseases;
  • sexually transmitted infections

Published Papers (2 papers)

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Research

12 pages, 530 KiB  
Article
Incident Chlamydia trachomatis Infection in a High School Population
by M. Jacques Nsuami, Wato Nsa, Catherine L. Cammarata, David H. Martin and Stephanie N. Taylor
Biology 2022, 11(9), 1363; https://doi.org/10.3390/biology11091363 - 17 Sep 2022
Viewed by 1638
Abstract
Prospective cohort studies of sexually transmitted infections (STIs) are logistically impractical owing to time and expenses. In schools, students are readily available for school-related follow-ups and monitoring. Capitalizing on the logistics that society already commits to ensure regular attendance of adolescents in school, [...] Read more.
Prospective cohort studies of sexually transmitted infections (STIs) are logistically impractical owing to time and expenses. In schools, students are readily available for school-related follow-ups and monitoring. Capitalizing on the logistics that society already commits to ensure regular attendance of adolescents in school, a school-based STI screening in New Orleans made it possible to naturally observe the occurrence of chlamydia and to determine its incidence among 14–19-year-old adolescents. Among participants screened repeatedly, we calculated incidence rates, cumulative incidence, and incidence times. Male (n = 3820) and female (n = 3501) students were observed for 6251 and 5143 person-years, respectively, during which 415 boys and 610 girls acquired chlamydia. Incidence rates per 100 person-years were 6.6 cases for boys and 11.9 cases for girls. In multivariable analysis, the adjusted hazard ratio was 5.34 for boys and 3.68 for girls if the student tested positive for gonorrhea during follow-up, and 2.76 for boys and 1.59 for girls if at first participation the student tested positive for chlamydia, and it increased with age among boys but not among girls. In joinpoint trend analysis, the annual percentage change in the incidence rate was 6.6% for boys (95% CI: −1.2%, 15.1%) and 0.1% for girls (95% CI: −5.3%, 5.7%). Annual cumulative incidence was 5.5% among boys and 8.6% among girls. Median incidence time was 9.7 months for boys and 6.9 months for girls. Our findings can be used to refine assumptions in mathematical modeling and in cost analysis studies of C. trachomatis infection, and provide strong evidence in support of annual chlamydia screening for adolescent boys. Full article
(This article belongs to the Special Issue School-Based STD Screening)
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12 pages, 882 KiB  
Article
Adolescents Accessing School-Based versus Family Planning Clinics: Chlamydia and Gonorrhea Testing and Treatment Outcomes
by Meghna Raphael, Allyssa A. Abacan, Peggy B. Smith and Mariam R. Chacko
Biology 2022, 11(4), 521; https://doi.org/10.3390/biology11040521 - 29 Mar 2022
Viewed by 1736
Abstract
The prevalence and treatment of chlamydia (CT) and gonorrhea (GC) at school-based clinics (SBCs) requires revisiting. To assess whether clinic type influences CT/GC testing and treatment for minors (individuals 13–17 years of age), our study compared four SBCs with five family planning clinics [...] Read more.
The prevalence and treatment of chlamydia (CT) and gonorrhea (GC) at school-based clinics (SBCs) requires revisiting. To assess whether clinic type influences CT/GC testing and treatment for minors (individuals 13–17 years of age), our study compared four SBCs with five family planning clinics (FPCs) in the Houston, Harris County metropolitan area of Texas, USA for: (1) the prevalence of CT/GC infection (pre-COVID-19 and during COVID-19); (2) treatment rates at the last positive diagnosis; and (3) the time, in days, from testing-to-diagnosis and testing-to-treatment. Between January 2019 and December 2020, 2439 unique patients (1579 at SBCs, 860 at FPCs) were seen. Of the 1924 tests obtained, 39.2% and 15.9% were positive for CT and GC, respectively. The prevalence of CT and GC at SBCs was similar prior to COVID-19 vs. during the COVID-19 pandemic. SBCs were able to provide treatment significantly faster after diagnosis (mean, 6.07 days; 95% CI, 3.22–8.90; 94.7% were within 30 days) than FPCs (mean, 17.60 days; 95% CI, 10.15–25.12; 84.7% were within 30 days) (p = 0.0257). This comparison within our large clinic system, with consistent clinical management protocols, suggests that SBC care may be critical to ensuring optimal sexually transmitted infection management in minors. Full article
(This article belongs to the Special Issue School-Based STD Screening)
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