{
  "abstract": "Introduction Syndromic management remains the primary approach for identifying and treating sexually transmitted infections (STIs) in low-resource settings. While faster and inexpensive, it leads to overtreatment, undertreatment and missed opportunities for surveillance. Recent advances in point-of-care (POC) diagnostic technologies for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and other STIs present new opportunities to improve STI management.Methods In September 2024, the Gates Foundation convened a 3-day expert meeting in Nairobi, Kenya, bringing together 44 global and national experts in STI diagnostic development, implementation research, policy, regulatory affairs and clinical practice. The objective was to identify priorities and strategies for advancing the introduction and scale-up of STI POC testing in low-resource settings with a focus on sub-Saharan Africa.Results Participants identified opportunities and barriers for introducing STI POC testing at various levels: individual client, health service delivery, national and global. At the individual client level, recommendations to optimise testing uptake included identifying and piloting strategies to improve knowledge about STIs and testing as well as addressing barriers to testing. At the health service delivery level, recommendations were to optimise clinical workflows, consider testing outside traditional health facilities (including private pharmacies), encourage self-collection and improve partner notification. At the national level, recommendations included updating treatment guidelines to incorporate diagnostic testing, strengthening laboratory quality assurance for STI tests and advocating for the public health importance of STIs, which remain underprioritised. This also involves building political commitment. At the global level, recommendations included harmonising regulatory requirements across regions, leveraging WHO prequalification processes, and expanding manufacturing capacity through technology transfer.Conclusions Effective introduction of STI POC diagnostics in low-resource settings will require coordinated efforts across global and national levels. Successful introduction, while ensuring equitable access, will accelerate access to quality STI care, reduce antimicrobial resistance and improve STI control outcomes.",
  "authors": [
    {
      "affiliations": [
        "Gates Foundation, Seattle, Washington, USA"
      ],
      "name": "Griffins O Manguro"
    },
    {
      "affiliations": [
        "Gates Foundation, Seattle, Washington, USA"
      ],
      "name": "Jill Ray"
    },
    {
      "affiliations": [
        "Advance Global Health, Washington, District of Columbia, USA"
      ],
      "name": "Celina Schocken"
    },
    {
      "affiliations": [
        "Jhpiego Corporation, Nairobi, Kenya"
      ],
      "name": "Daniel K Were"
    },
    {
      "affiliations": [
        "Quantigen, Fishers, Indiana, USA"
      ],
      "name": "Victor O Omballa"
    },
    {
      "affiliations": [
        "World Health Organization, Geneva, Switzerland"
      ],
      "name": "Cheryl C Johnson"
    },
    {
      "affiliations": [
        "The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe",
        "MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Chido Dziva Chikwari"
    },
    {
      "affiliations": [
        "AVAC, New York, New York, USA"
      ],
      "name": "Alison Footman"
    },
    {
      "affiliations": [
        "Gates Foundation, Seattle, Washington, USA"
      ],
      "name": "Lori M Newman"
    },
    {
      "affiliations": [
        "World Health Organization, Geneva, Switzerland"
      ],
      "name": "Remco P H Peters"
    }
  ],
  "title": "From syndromic management to diagnostic-led management: a report from an expert meeting on introducing sexually transmitted infection testing in low-resource settings",
  "uid": "bb8dcd87-75c7-58b3-82e3-b67d1c0060e6"
}