Project

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Improving neonatal and infant outcomes using point-of-care tests for sexually transmitted infections in high prevalence settings (neoSTI project)

Applicant Low Nicola Minling
Number 160909
Funding scheme r4d (Swiss Programme for Research on Global Issues for Development)
Research institution Institut für Sozial- und Präventivmedizin Universität Bern
Institution of higher education University of Berne - BE
Main discipline Infectious Diseases
Start/End 01.10.2016 - 31.12.2022
Approved amount 499'444.00
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All Disciplines (3)

Discipline
Infectious Diseases
Paediatrics
Gynaecology

Keywords (6)

community involvement; prevention; mother to child transmission; infant development; neonates; sexually transmitted infections

Lay Summary (German)

Lead
Verbesserung des Gesundheitszustands von Neugeborenen und Kindern nach Mutter-Kind-Übertragung von sexuell übertragbaren Infektionskrankheiten in Papua Neu GuineaSexuell übertragbare Infektionskrankheiten während der Schwangerschaft sind wichtige, jedoch oft vernachlässigte Gründe, welche sowohl in der Schwangerschaft als auch nach der Geburt zu Komplikationen wie Frühgeburtlichkeit, niedrigem Geburtsgewicht, Bindehautentzündung, Lungenentzündung und Neugeborenentod führen können. Papua Neu Guinea hat weltweit eine der höchsten Raten an sexuell übertragbaren Infektionen wie Chlamydien und Gonorrhoe (Tripper). Zudem weist Papua Neu Guinea eine mangelhafte Gesundheitsversorgung auf.
Lay summary

Inhalt und Ziele des Forschungsprojekts

Das primäre Ziel des Projekts ist, die Wirksamkeit der Anwendung von Schnelltests für sexuell übertragbare Krankheiten in der Schwangerschaft auf Erkrankungen beim Neugeboren (Augeninfektionen und Lungenentzündungen) zu überprüfen. Unser Projekt untersucht, wie sich der in der Schwangerschaft durchgeführte Schnelltest auf die Gesundheit des Neugeborenen auswirkt und knüpft an das Projekt WANTAIM* an. WANTAIM vergleicht die Anwendung von Schnelltests auf sexuell übertragbare Infektionskrankheiten in der Schwangerschaft mit der routinemässigen Schwangerenvorsorge und wird von Wissenschaftler aus Papua Neu Guinea und Australien durchgeführt.

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojekts

Erkenntnisse aus dem Projekt können die Gesundheit von Neugeborenen in Papua Neu Guinea und anderen Ländern verbessern. Eingeschränkte kindliche Gesundheit hat schwerwiegende soziale und wirtschaftliche Auswirkungen. Die Umsetzung der Ergebnisse in den Bereich der öffentlichen Gesundheit und in die Praxis kann zu einer Verbesserung der Gesundheitslage führen.

 

*Wantaim (Women And Newborn Trial of Antenatal Interventions and Management) bedeutet „zusammen“ und hat zum Ziel, dass Angehörige und Gemeinschaften zusammen kommen, um die Gesundheit von Müttern und ihren Neugeborenen zu stärken. Wie der Name bereits sagt, fokussiert die Studie auf die Verbesserung bestehender Gesundheitssysteme. WAN TAIM kann auch interpretiert werden als „one time“ und wiederspiegelt das „point of care“ Testverfahren.

Direct link to Lay Summary Last update: 03.08.2016

Responsible applicant and co-applicants

Employees

Publications

Publication
Sexually transmitted infections in pregnancy: a narrative review of the global research gaps, challenges, and opportunities
Grant Juliana, Chico Matthew, Lee Anne, Low Nicola, Medina-Marino Andrew, Molina Rose, Morroni Chelsea, Ramogola-Masire Doreen, Stafylis Chrysovalantis, Tang Weiming, Vallely Andrew, Wynn Adriane, Yeganeh Nava, Klausner Jeffrey (2020), Sexually transmitted infections in pregnancy: a narrative review of the global research gaps, challenges, and opportunities, in Sexually Transmitted Diseases, 1.
Mycoplasma genitalium incidence, persistence, concordance between partners and progression: systematic review and meta-analysis
Cina Manuel, Baumann Lukas, Egli-Gany Dianne, Halbeisen Florian S, Ali Hammad, Scott Pippa, Low Nicola (2019), Mycoplasma genitalium incidence, persistence, concordance between partners and progression: systematic review and meta-analysis, in Sexually Transmitted Infections, 95(5), 328-335.
Point-of-care testing and treatment of sexually transmitted infections to improve birth outcomes in high-burden, low-income settings: Study protocol for a cluster randomized crossover trial (the WANTAIM Trial, Papua New Guinea)
Vallely Andrew J., Pomat William S., Homer Caroline, Guy Rebecca, Luchters Stanley, Mola Glen D. L., Kariwiga Grace, Vallely Lisa M., Wiseman Virginia, Morgan Chris, Wand Handan, Rogerson Stephen J., Tabrizi Sepehr N., Whiley David M., Low Nicola, Peeling Rosanna, Siba Peter, Riddell Michaela, Laman Moses, Bolnga John, Robinson Leanne J., Morewaya Jacob, Badman Steven G., Batura Neha, et al. (2019), Point-of-care testing and treatment of sexually transmitted infections to improve birth outcomes in high-burden, low-income settings: Study protocol for a cluster randomized crossover trial (the WANTAIM Trial, Papua New Guinea), in Wellcome Open Research, 4, 53-53.
Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae, Mycoplasma genitalium, M. hominis, Ureaplasma urealyticum and U. parvum: a systematic review and meta-analysis protocol
Vallely Lisa M, Egli-Gany Dianne, Pomat William, Homer Caroline SE, Guy Rebecca, Wand Handan, Silver Bronwyn, Rumbold Alice R, Kaldor John M, Low Nicola, Vallely Andrew J (2018), Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae, Mycoplasma genitalium, M. hominis, Ureaplasma urealyticum and U. parvum: a systematic review and meta-analysis protocol, in BMJ Open, 8(11), e024175-e024175.
Prevalence of Mycoplasma genitalium in different population groups: systematic review and meta-analysis
Baumann Lukas, Cina Manuel, Egli-Gany Dianne, Goutaki Myrofora, Halbeisen Florian S, Lohrer Gian-Reto, Ali Hammad, Scott Pippa, Low Nicola (2018), Prevalence of Mycoplasma genitalium in different population groups: systematic review and meta-analysis, in Sexually Transmitted Infections, 94(4), 255-262.

Collaboration

Group / person Country
Types of collaboration
PNG Institute of Medical Research, Sexual and Reproductive Health Unit PapuaNew Guinea (Oceania)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
University of New South Wales, Kirby Institute Australia (Oceania)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
STI & HIV 2019 World Congress Poster Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae: A systematic review and meta-analysis 14.07.2019 Vancouver, Canada Low Nicola Minling; Vallely Andrew; Egli-Gany Dianne;
r4d forum open call Poster Point-of-care testing and treatment of sexually transmitted infections to improve birth outcomes in high-burden, low-income settings: the WANTAIM Trial, Papua New Guinea 19.09.2017 Bern, Switzerland Low Nicola Minling; Egli-Gany Dianne;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
WANTAIM Communication Events and Workshops Workshop 08.11.2019 Provinces of Madang and Kokopo, PapuaNew Guinea Laman Moses; Vallely Andrew; Pomat William;


Communication with the public

Communication Title Media Place Year
Other activities WANTAIM project website International 2019

Associated projects

Number Title Start Funding scheme
176233 Zika virus: causality, open science and risks of emerging infectious diseases 01.11.2017 Project funding (Div. I-III)

Abstract

Background:Sexually transmitted infections (STI) in pregnancy are important but neglected causes of poor pregnancy and neonatal outcomes, including preterm birth, low birthweight, ophthalmia neonatorum, pneumonia and neonatal death. Papua New Guinea (PNG) has some of the highest rates of STI (such as Chlamydia trachomatis and Neisseria gonorrhoeae) in the world and poor maternal, neonatal and infant health indicators. The lack of accurate tests to diagnose STI in women has been a major barrier to prevention. New diagnostic technologies now allow accurate diagnosis at the point-of-care (POC).This project aims to prevent neonatal infections resulting from mother to child transmission of STI. The project extends the Women and Newborn Trial of Antenatal Interventions and Management (Wantaim), a cluster-randomised crossover trial in three provinces in PNG. Women in the intervention arm will be offered POC testing for STI, including C. trachomatis (CT) and N. gonorrhoeae (NG), at antenatal visits. Women in the control arm will receive standard antenatal care. The primary outcomes of the Wantaim project are preterm birth and low birthweight. The project take place in a research framework that has used community participatory methods for mobilisation, liaison and feedback.Objectives: 1. To evaluate whether point-of-care STI testing and treatment in pregnancy leads to a reduction in neonatal eye infection and/or pneumonia compared with standard antenatal care; 2. To evaluate mother to child transmission of C. trachomatis and N. gonorrhoeae; 3. To evaluate the performance of the Xpert™ CT/NG Test for the diagnosis of neonatal eye infection and pneumonia using ocular and nasopharyngeal specimens. Methods: This study will enrol approximately 2,000 women and their newborns. We will collect samples from mothers within 48 hours of delivery and samples from newborns at 1-2 weeks and 4-6 weeks after birth. At six months of age we will assess physical health and development.Outcomes:Primary outcome: Proportion of newborns with an eye infection or moderate/severe pneumonia by 4-6 weeks postnatal.Secondary outcomes:i) Incidence of infection as indicated by positive newborn eye (C. trachomatis or N. gonorrhoeae) or nasopharyngeal (C. trachomatis) swabs by 4-6 weeks postnatal; ii) Diagnostic test accuracy of Xpert™ CT/NG Test compared with nucleic acid amplification tests.Outputs:This project will provide data about the effect of antenatal POC testing for STI on neonatal and infant health and development. If successful, the research outputs will be introduced into policy and practice.
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