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Results: 18

Interventions for treating genital chlamydia trachomatis infection in pregnancy

Chlamydia is a sexually transmitted infection which, if a mother has it during pregnancy and labour, can cause eye or lung infections in the newborn baby. The risk of transmission during birth varies, but is about 20% to 50% for eye infections and about 10% to 20% for infection of the lungs. Mothers may also be at increased risk of infection of the uterus. The review looked at various antibiotics being used during pregnancy to reduce these problems and to assess any adverse effects. Tetracyclines taken in pregnancy are known to be associated with teeth and bone abnormalities in babies, and some women find erythromycin unpleasant to take because of feeling sick and vomiting. The review found eleven trials, involving 1449 women, on erythromycin, amoxycillin, azithromycin and clindamycin, and the overall trial quality was good. However, all the trials assessed 'microbiological cure' (that is they looked for an eradication of the infection) and none assessed whether the eye or lung problems for the baby were reduced. Also, none of the trials were large enough to assess potential adverse outcomes adequately. The review found amoxycillin was an effective alternative to erythromycin but lack of long‐term assessment of outcomes caused concern about its routine use in practice. If erythromycin is used, some women may stop taking it because of adverse effects. Azithromycin and clindamycin are potential alternatives. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Home‐based specimen collection in the management of chlamydia and gonorrhoea infections

Review question: Cochrane authors reviewed evidence about the effects of self‐collected specimens at home compared with specimens collected at clinic on the clinical management of chlamydia and gonorrhoea infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Face washing promotion for preventing active trachoma

We investigated whether face washing prevents active trachoma in endemic communities.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Population‐based interventions for reducing HIV infection

Community‐ or population‐based sexually transmitted infection control does not appear to be an effective HIV prevention strategy in most settings. In the early 1990s, improved STI treatment services were shown to reduce HIV incidence in northern Tanzania, in an environment characterised by an emerging HIV epidemic, where STI treatment services were poor and where STIs were highly prevalent. Subsequent trials, however, failed to confirm these findings and also failed to show a substantial benefit for community‐wide presumptive treatment for STIs. This is likely due to the endemic nature of HIV and relatively low incidence of STIs in these populations. There are, however, other good reasons as to why STI treatment services should be strengthened and the available evidence suggests that when an intervention is applied and accepted in a community, it can improve the quality of services provided. The trial in Masaka District, Uganda showed an increase in the use of condoms, a marker for less risky sexual behaviours, although a newer study by Gregson conducted in Zimbabwe suggested no effect. With the last three trials having shown disappointing results with respect to HIV prevention, it is unlikely that further community trials will be conducted, let alone yield different results. Future trials of biomedical interventions that involve individual randomisation, however, may represent an opportunity to reexamine presumptive treatment of STIs. Such trials should also aim to measure a range of factors that include health‐seeking behaviour and quality of treatment, as well as HIV, STI and other biological endpoints.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Antibiotics reduce the prevalence of ocular infection with trachoma

Trachoma is common in people living in poor communities and is the most common infectious cause of vision loss. Repeated bouts of conjunctivitis (inflammation of the membranes of the eyes) caused by Chlamydia infection eventually lead to scarring and inward turning of the eyelid. The lashes rub on the cornea causing opacification and blindness. Antibiotics can be used to treat the Chlamydia infection and may be given as an ointment or by mouth. This review included 14 trials in 3587 people with ocular trachoma and eight community‐based trials (67 communities). Antibiotic treatment reduce conjunctivitis caused by trachoma ('active trachoma') and ocular infection in individuals. Community‐based trials provided evidence that azithromycin treatment reduces the prevalence of active trachoma and ocular Chlamydia infection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Interventions for trachomatous trichiasis

Trachoma is the commonest infectious cause of blindness in the world. It is caused by a bacterium called Chlamydia trachomatis. This infection causes inflammation and scarring of the surface of the eye, which results in the eyelid turning in (entropion) so that the eyelashes touch the eyeball. This is known as trachomatous trichiasis. The lashes can scratch the corneal surface, leading directly or indirectly (from secondary infections) to corneal opacity. Surgery to correct the eyelid deformity is the main treatment for the late stages of the disease. Most cases of trachomatous trichiasis occur in sub‐Saharan Africa. They are generally treated by nurses with limited surgical training. Unfortunately the results of the surgery can be quite variable, with frequent post‐operative trichiasis reported. Therefore, we wanted to find out what types of surgery and other interventions give the best results in treating this condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Strategies for partner notification for sexually transmitted infections, including HIV.

Sexually transmitted infections (STI) are a major global cause of acute illness, infertility and death. Every year there are an estimated 499 million new cases of the most common curable STIs (trichomoniasis, chlamydia, syphilis and gonorrhoea), and between two and three million new cases of HIV. The presence of several STIs, including syphilis and herpes can increase the risk of acquiring or transmitting HIV.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Which screening tests are paid for by statutory health insurance funds in Germany?

Children and adults have the option of having various screening tests. Statutory health insurance funds in Germany cover the costs of many of these screening tests for certain groups of people.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 4, 2014

Environmental sanitation measures to reduce trachoma transmission

Trachoma is the commonest cause of preventable vision loss and is common in poor communities. Repeated bouts of conjunctivitis caused by chlamydia infection lead to scarring and turning in of the eyelid. The lashes rub the cornea causing opacification and blindness. Environmental sanitation is a package of measures aimed at eliminating factors that encourage proliferation of flies and the spread of the disease. Some of these interventions include provision of water and latrines as well insecticide spray to control flies and health education programmes to improve the personal and environmental hygienic practices of the people. We included six studies involving 12,294 participants of different ages and both sexes in this review. The trials were conducted in The Gambia, Mali, Tanzania, Niger and Ethiopia. Two studies looked at insecticide spray, one looked at insecticide spray and provision of latrines, one study looked at provision of latrines, and two studies looked at health education with one of them having health education combined with water supply. Prevalence of active trachoma, prevalence of Chlamydia trachomatis and fly count measures were the main outcomes assessed. Two studies conducted in the same area found insecticide spray effective in reducing active trachoma but one study in a different setting found the spray ineffective. A separate study found health education on personal and environmental hygiene to be effective in reducing active trachoma, however, another study found that a modest health education programme combined with a modest water supply was not effective in reducing active trachoma. One study on latrine provision found no impact on trachoma. However, more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Nonoxynol‐9 for preventing vaginal acquisition of sexually transmitted infections by women from men

There is good evidence that nonoxynol‐9 does not protect against sexually transmitted infections (STI), and there is some evidence that it may be harmful by increasing the rate of genital ulceration. As such, this product cannot be recommended for STI prevention.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Interventions for encouraging sexual behaviours intended to prevent cervical cancer

Young women are at high risk of contracting sexually transmitted infections (STIs), including types of human papillomavirus (HPV) that can cause cervical cancer. High rates of STIs among young people highlight a need for effective strategies to prevent the spread of infections. Although behavioural approaches (e.g. using condoms consistently) could protect against STIs and cervical cancer, there is a lack of evidence on which strategies would be most effective in practice. This systematic literature review was conducted to identify which types of behavioural strategy have been tested and to assess their effectiveness.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Antibiotics to treat respiratory infections caused by the bacteria Mycoplasma pneumoniae in children

This review sought to answer the question of whether antibiotics are effective in the treatment of LRTIs caused by the bacteria Mycoplasma pneumoniae (M. pneumoniae) in children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Interventions to treat chronic infection of the prostate gland (chronic bacterial prostatitis)

Chronic bacterial prostatitis (CBP) involves infection and inflammation of the prostate gland in men of all ages. It can cause problems urinating, including discomfort and pain, increased frequency and urge, or problems emptying the bladder. Bacteria infecting the prostate are the cause of CBP. These bacteria may be sexually transmitted. To cure CBP, antibiotics must be administered for extended periods of time (four weeks or longer), but a permanent cure is not always guaranteed. Other drugs may be combined with antibiotics to improve CBP symptoms. This review found that fluoroquinolones like ciprofloxacin, levofloxacin, lomefloxacin, ofloxacin or prulifloxacin have equivalent effects and equivalent success rates in CBP patients. If atypical bacteria like chlamydia are suspected to cause CBP, macrolide antibiotics such as azithromycin may achieve better results compared to the fluoroquinolone ciprofloxacin. It must be taken into account that some of the studies that have been performed are of poor quality or have been performed on small numbers of participants. More studies are needed, focusing on new agents or on optimized doses of currently prescribed antibiotics.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Initial antibiotic treatment for coverage of 'atypical' pathogens for community‐acquired pneumonia in hospitalized adults

Pneumonia is a serious lung infection and is usually treated with antibiotics. Bacteria which cause community‐acquired pneumonia (CAP, pneumonia contracted outside healthcare settings) are traditionally divided into 'typical' and 'atypical', each dictating a different antibiotic treatment. Atypical bacteria include, Legionella pneumophila (L. pneumophila), Mycoplasma pneumoniae (M. pneumoniae) and Chlamydia pneumoniae (C. pneumoniae). The main 'typical' agent causing CAP is Streptococcus pneumoniae (S. pneumoniae). It is usually not possible to determine which of the many potential agents is the cause of CAP, so that antibiotic treatment is empirical, customarily covering both typical and atypical bacteria. While typical coverage is essential, the necessity of the atypical coverage has not been proven. In the previous version of this review we showed that there was no advantage to the atypical arm. Given the persisting inconsistency between current guidelines for treatment of pneumonia and the available evidence, we undertook to update this systematic review.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Topical microbicides for prevention of sexually transmitted infections

Microbicide research has had disappointing outcomes during the last two decades as most microbicides have not shown evidence that they can prevent acquisition of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). However, a recent small preliminary study suggests that microbicides containing the antiretroviral drug tenofovir may prevent acquisition of HIV and herpes simplex virus infection in women; but further research is needed to assess the generalisability of these findings. Therefore, there is not enough evidence to recommend topical microbicides for HIV or STI prevention at present.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Contraception: How do the contraceptive skin patch and vaginal ring compare with the pill?

The contraceptive skin patch, vaginal ring and pill are similarly effective forms of contraception. But the skin patch is associated with more side effects than the other two hormonal contraceptives.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 24, 2013

The effect of financial incentives on the quality of health care provided by primary care physicians

The use of different ways of paying primary care physicians in an attempt to increase quality of care, including the use of financial incentives to directly reward ‘performance’ and ‘quality’, is increasing in a number of countries. There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system‐wide reform. Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost‐effective relative to other ways to improve the quality of care. The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs). There is insufficient evidence to support or not support the use of financial incentives to improve the quality of primary health care. Implementation should proceed with caution and incentive schemes should be carefully designed and evaluated.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

The effectiveness of community interventions to promote condom use in the prevention of HIV and sexually transmitted infections

Since the advent of the HIV/AIDS epidemic in the 1980s, condom promotion has become one of the most widely used interventions to prevent transmission of HIV and sexually transmitted infections (STIs). However, despite widespread promotion of condom use globally, new cases of HIV and other STIs either remain high or continue to rise in some particular regions and settings across the world. It is believed that by modifying the environment in which people live, it is possible to improve access and use of condoms on a large scale so that the transmission of HIV and other STIs decreases. This review aimed to assess if this theory was correct.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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