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Table 3 Key research area’s in understanding the clinical and public health impact of extra-genital Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in women and in men who have sex with men (MSM)

From: What is needed to guide testing for anorectal and pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae in women and men? Evidence and opinion

Key research area Knowledge Gap on extra-genital CT and NG infections in women and MSM
Morbidity Proctitis in anorectal infections
  Reproductive morbidity (women)
Efficacy control strategies: Treatment Efficacy of treatment for both extra-genital and genital infections and associated factors (including treatment resistance, tissue absorption, duration of treatment to account for CT life cycle phases)
Efficacy control strategies: Re-testing, partner management Efficacy of strategies to manage extra-genital infections (including strategies that are already taken to manage genital infections)
Transmission Transmission risk between sexual partners and associated factors, such as bacterial load, sexual behavior
  Self-infection, i.e. transmission risk between anatomic sites within a patient and associated factors, i.e. bacterial load, sexual behavior (women)
  Role in the transmission of other STI including HIV
Detection Microbiologic specifics of a CT - NAAT detection such as bacterial load, viability or other possible markers of transmission or of morbidity
Testing policy Cost effectiveness of extra-genital CT and NG testing taking into account the key research area’s of efficacy of extra-genital control-strategies, transmission and morbidity