Lockdown consequences: Sexually Transmitted Infections have decreased, but is going digital the future for diagnosis?
As much of the world spent huge parts of 2020 and 2021 in lockdown, it is perhaps no great surprise that the number of new reported cases of sexually transmitted disease (STD) have fallen
Whilst that positive unintended consequence of government intervention in the global pandemic may initially seem a good thing, it’s also just as likely that as countries get to grips with COVID and restrictions are lifted that those who were abstinent through those periods are very keen to get out and socialise again. It is almost inevitable that there will be a sudden increase in STDs as people unaware of their infection status suddenly begin interacting with others again.
A study in the lancet showed an almost 50% reduction in HIV testing in South Africa during the first lockdown, and consequently a reduction in the number of people who began antiretroviral treatment. Those trends are replicated elsewhere in the world. In Catalonia there was a 56% reduction in positive cases during lockdown and England there were 32% fewer sexually transmitted infections (STIs) diagnosed in 2020 than 2021.
Interestingly though Public Health England report that the number of internet consultations for sexual health services doubled from 2019 to 2020. That trend seemed to remain high even in months where England was not in lockdown. Suggesting that service users prefer to access the service digitally, either for convenience or perceived better anonymity. If such a trend continues it is likely that increasingly people will be asked to either swab or test themselves for STDs. Afterall, if we have trusted the public to test themselves in the midst of a pandemic, which has shut country borders, closed schools and crippled health services and which is so prevalent and easily transmitted that there is no embarrassment at being infected, we can surely help people to discretely access testing where there may be some stigma.
With over 1 million new cases of STI each day the problem is not going away. Much like COVID, the challenge is how can we identify the cases so we can take early, appropriate interventions, which not only increase the prospects for that patient, but break the chains of transmission.
Home test kits for HIV have been gradually gaining regulatory approval over the last few years, and self-swabbing for other infections is increasingly common. We’ve noticed with COVID that virtually everyone believes that they are able to perform the test and consider their own eyesight and integrity good enough to be accurate about results but suspect that others may be less so. In fact, we know from studies on lateral flow type tests that user error is actually quite common, and some of those errors can result in misdiagnosis.
Obviously, a critical factor in ensuring the accuracy of any test is the quality of the reagents. In the case of HIV, it is most common to detect both the HIV p24 viral antigen, as well as a patient’s antibodies against the p24 antigen. To accomplish that, both high quality anti-HIV p24 antibodies and HIV p24 antigen are necessary.
BBI has developed both p24 antibodies and antigen to help manufacturers develop better diagnostics, whether in automated laboratory systems or in the simple to use home test kits, where the antibodies will often be combined with our industry leading gold-nanoparticles, which create the red lines that the public have all become so familiar with.
A trend that has become clear over the last 18 months is the use of digital technology to book consultations, record results and share medical information, and it’s one we expect is here to stay.
BBI, through its Novarum technology has been developing tools to support diagnostic companies and healthcare providers for nearly 10 years, having been at the forefront of mobile technology making inroads to lateral flow testing. Increasingly we see both manufacturers and healthcare providers looking to create joined up testing services, linking the simplicity of lateral flow test, or self-collected swabs with patient consultation videos, test traceability, result certification, and long-term monitoring.
Whether it’s a digital need or fundamental biological reagent and whether you are looking to develop your next generation diagnostic test or find ways to redeploy your existing platform, the team at BBI would be interested to hear from you.
Author: Dr. Neil Polwart
Head of Mobile