STBBI: Guides for health professionals: Summary of Recommendations for Chlamydia trachomatis (CT),Neisseria gonorrhoeae (NG) and Syphilis
Tips for screening, treatment and follow-up of bacterial STBBI
Reported cases of STBBI in Canada are increasing (2019)
139,386 cases of Chlamydia trachomatis (CT)
- 74% of cases were aged 15 to 19
- 58% of cases were female
35,443 cases of Neisseria gonorrhoeae (NG)
- 51% of cases were aged 15 to 29
- 66% of cases were male
9,245 cases of infectious Syphilis
- 72% of cases were male
- Among females aged 15 to 39 years, rates were 18 times higher than in 2010
Organization: Public Health Agency of Canada
Published: 2023-08-11
Type: Infographic
ISBN: 978-0-660-47378-9
Cat: HP40-250/2023E-PDF
Pub.: 220748
Do you know if the person in front of you has ever been screened for sexually transmitted and blood-borne infections (STBBI)?
In 2018, over 50% of Canadians reported that they had never been screened for STBBI.
Normalize discussions about sexual health and offer STBBI screening to sexually active people as part of routine care.
- Screening is an opportunity to discussion transmission, signs and symptoms, risk reduction and preventive strategies.
- Undiagnosed and untreated STBBI can lead to serious complications, e.g. pelvic inflammatory disease (PID), epididymo-orchitis, adverse pregnancy outcomes
Offer annual screening to:
- Individuals < 25 years old
- Gay, bisexual and other men who have sex with men (gbMSM)
- Transgender persons
Offer screening to people ≥ 25 years old based on risk factorsFootnote +
Offer screening routinely during pregnancy
CT and NG:
- Screen in the 1st trimester or at the 1st prenatal visit AND in the 3rd trimester
- Screen during labour if: no prenatal screening has occurred (no results are available) OR 3rd trimester screening did not occur OR follow-up for a positive result was not completed
Syphilis:
- Screen in the 1st trimester or at the 1st prenatal visit
- Screen between 28 and 32 weeks of pregnancy AND during labour in areas experiencing outbreaks AND for people at ongoing risk for infectionFootnote +
More frequent screening may be appropriate for those with ongoing risk factors for STBBIFootnote +
STBBI are often asymptomatic. Screen for one STBBI, screen for all!
Screening: Early STBBI detection in asymptomatic individualsFootnote †
Tips
- Nucleic Acid Amplification Test (NAAT) is highly sensitive and the test of choice when screening asymptomatic individuals for CT and NG
- Preferred specimens for NAAT are first void urine or self-collected vaginal swab
- Collect pharyngeal and rectal specimens from individuals with a history of performing oral sex or having receptive anal intercourse, respectively
- Check with your laboratory for the availability of NAAT for rectal and pharyngeal specimens
- Collect specimens for both CT and NG due to high rates of co-infection
- When NG is suspected, collect specimens for NAAT AND culture
- Culture permits antimicrobial susceptibility testing to guide treatment
- Ideally, collect specimens prior to empirical/epidemiological treatment
Offer HIV testing when screening for other STBBIFootnote †
Tips
- Testing algorithms may vary by province and territory
Offer HIV testing when screening for other STBBI.Footnote †
Early diagnosis and treatment lead to better health outcomes
Chlamydia trachomatis (CT) | Neisseria gonorrhoeae (NG) | Syphilis |
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OR
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For anogenital and pharyngeal infections
OR For anogenital infections
Note: Cefixime is not the preferred treatment for gbMSM |
For infectious syphilis (primary, secondary and early latent)
For late latent syphilis
|
Tips
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Tips
|
Chlamydia trachomatis (CT) | Neisseria gonorrhoeae (NG) | Syphilis |
---|---|---|
TOC using NAAT 3 - 4 weeks after the completion of treatment is recommended only when:
|
Routine TOC is recommended:
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Indications for post-treatment monitoring and follow-up serology:
|
Tips
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Tips
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Consult the STBBI: Guides for health professionals for more detailed information.
Recommendations do not supersede any provincial/territorial legislative, regulatory, policy and practice requirements or professional guidelines that govern the practice of health professionals in their respective jurisdictions, whose recommendations may differ due to local epidemiology or context.
Additional info:
- STBBI: Guides for health professionals(PHAC)
- HIV Fact Sheet: Screening and Testing (PHAC)
- Discussing sexual health, harm reduction and STBBIs: A guide for service providers (CPHA)
- Reducing stigma and discrimination through the protection of privacy and confidentiality (CPHA)
Learn more: visit Canada.ca and search Sexual Health or download the Canadian STBBI Guides mobile application.
Footnotes
- Footnote 1
-
Risk factors for STBBI acquisition include but are not limited to: previous STBBI diagnosis, new sexual partners, multiple or anonymous sexual partners, sexual partners having a STBBI, condomless sex and sex while under the influence of alcohol or drugs
- Footnote 2
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For HIV specific guidance consult the HIV Factsheet: Screening and Testing available on Canada.ca
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