European Conference of National Strategies for Chlamydia Trachomatis and Human Papillomavirus (NSCP)
|Event Date/Time: May 26, 2011||End Date/Time: May 27, 2011|
|Registration Date: May 15, 2011|
|Early Registration Date: Feb 01, 2011|
|Abstract Submission Date: Mar 01, 2011|
Purpose of the Conference is to provide guidance in the European Union about national strategies for Chlamydia trachomatis and human papillomavirus (HPV) early detection and control. It will provide an framework for developing, implementing or improving national strategies to control of Chlamydia trachomatis and HPV. Health policies, like clinical guidelines, should be based on the best available evidence. In this Conference we will aim to facilitate the development of local, evidence-based guidelines within the context of sound national strategies. Such strategies need to take account not only of clinical and epidemiological factors (such as the prevalence in the population) but also of local systems of health care delivery, infrastructure and resourcing.
Objective of the Conference is evaluation and developing of Chlamydia trachomatis and HPV current control programs. Control programs aim to reduce the prevalence diseases, but this is difficult to monitor as it requires periodic population surveys of the population. However, there are many other indicators of the effectiveness which should be built into any program from the outset. At the national level, programs should monitor indicators relating to the policies and guidelines of the program, the implementation and processes, and the outcome of the program. These must be based on the specific objectives appropriate to the level of implementation. If countries move from one level of control to the next, they will need to make decisions based on a rigorous appraisal of the evidence for effectiveness, cost-effectiveness and harms. This will be assisted if countries ensure that all activities are fully evaluated and results shared with others in Europe. This way investments in programs made now will strengthen the evidence base for Chlamydia trachomatis and HPV control and facilitate future decision making and improve population health. At the European level, the objective should be to reduce the proportion of countries reporting no organized activity.
The new diagnostic tools are the most changing and developing part of Chlamydia and HPV national strategies and we anticipate innovative ideas concerning early detection and control of STI.
The role of molecular detection such as nucleic acid amplification tests (NAATs) and fingerprinting of microorganisms has shifted gradually from the academic world to the routine diagnostic laboratory and have been used increasingly over the past decade to improve the sensitivity, specificity and time performing in the clinical laboratory.
Despite the advantages and popularity of molecular diagnostic and fingerprinting methods, significant challenges must be addressed before these methods can be adopted in the clinical diagnostic laboratory. Sequence-based identification and strain typing, along with the development of probes for genetic markers, allows detailed strain fingerprinting. DNA fingerprint analysis can be used to study strain relatedness, as well as group heterogeneity for a particular organism. Thus, analysis can have a significant impact on patient management and disease control through early detection of disease clusters or outbreaks. This molecular typing has added a new dimension to studying the epidemiology of communicable diseases and the quantification of the extent of transmission.
Standard genotyping methods require either highly discriminative but heavy, and relatively expensive devices such as automated capillary electrophoresis devices, or cheaper, easy to use but more time consuming and with lower resolution power such as agarose gels. The new miniaturized platforms based on microfluidic nanotechnology for quantification and separation of nucleic acid molecules have shown accuracy, precision and high feasibility along with speed and moderate cost reagents. The platforms can also be easily used by low-expertise staff.
Discussions during the Conference concerning new advanced technologies like microfluidic nanotechnology will give innovative ideas for national Chlamydia and HPV strategies around the Europe.
The Conference will impact the development of national Chlamydia and HPV strategies. Now in the most European countries, Chlamydia and HPV testing is available at gynecology and STI clinics; it may also be provided by urology, primary care and family planning clinics. However, many countries do not have guidelines applicable to each setting. There is variation in the recommendations between different guidelines, for example in the need for repeat testing. The expected outcome of the Conference is the emphasis of the relevance to summarize the essentials of existing guidelines.
Nucleic acid amplification tests (NAATs) for Chlamydia and HPV detection are available in all European countries, but are not always used routinely. The impact of Conference shall be realized by recommendations for widely use of NAATs in Europe.
Most countries have a system for surveillance of Chlamydia infections. The most common system was a statutory requirement for all laboratory diagnosed chlamydia to be reported at the national level. However, in some countries only cases diagnosed in selected settings (e.g. STI and gynaecology clinics) are reported. Some countries had no reporting system for Chlamydia and about a third of EU Member States do not report Chlamydia surveillance data. The outcome of the Conference has to be the emphasis to develop the recommendation with aim to reduce the number of European countries without no reporting activities.
Many EU Member States indicated that no Chlamydia and/or HPV screening programme was in place. In some countries, asymptomatic individuals may be tested for Chlamydia and/or HPV when they attend health services. The groups targeted for such opportunistic screening vary between and within countries and such programmes are under development. For instance, pilot programmes using register-based postal invitations to find out Chlamydia cases are underway or planned in the Netherlands, Norway and Denmark. The outcome of the Conference shall be the emphasis of the relevance to analyze of such screening programmes including financial costs. It is not publicly available now.