Full Text Journal Articles by
Author Emma Harding Esch

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High prevalence of coinfection of azithromycin-resistant Mycoplasma genitalium with other STIs: a prospective observational study of London-based symptomatic and STI-contact clinic attendees.

Claire E Broad, Martina Furegato, Mark A Harrison, Marcus J Pond, NgeeKeong Tan, Sandra Okala, Sebastian S Fuller, Emma M Harding-Esch, S Tariq Sadiq,

OBJECTIVES:Azithromycin treatment of Chlamydia trachomatis (CT) may not be adequate to treat concomitant Mycoplasma genitalium (MG) infection, and particularly if MG has macrolide resistance-associated mutations (MG-MRAMs). We estimated prevalence of coinfections of CT with MG carrying MRAM, and risk factors for MG-MRAM among a sexual health clinic population. STUDY DESIGN ... Read more >>

Sex Transm Infect (Sexually transmitted infections)
[2020, :]

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Technologies, strategies and approaches for testing populations at risk of sexually transmitted infections: a systematic review protocol to inform prevention and control in EU/EEA countries.

Suzanna C Francis, Arun Parajuli, Otilia Mardh, Jane Falconer, Aura Andreasen, Emma Harding-Esch, ,

OBJECTIVES:This protocol outlines a systematic review methodology, aiming to assess the recent evidence-base for the impact of testing strategies and approaches on access to testing, testing coverage, and linkage to care for populations at risk for specific curable sexually transmitted infections (STIs) (chlamydia, gonorrhoea, syphilis, trichomoniasis, and Mycoplasma genitalium infections). ... Read more >>

Syst Rev (Systematic reviews)
[2020, 9(1):64]

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Mass drug administration with azithromycin for trachoma elimination and the population structure of Streptococcus pneumoniae in the nasopharynx

Rebecca Gladstone, Ebrima Bojang, John Hart, Emma Harding-Esch, David CW Mabey, Ansumana Sillah, Robin Bailey, Sarah Burr, Anna Roca, Stephen Bentley, Martin Holland,

Background: Mass drug administration (MDA) with azithromycin for trachoma elimination reduces nasopharyngeal carriage of Streptococcus pneumoniae in the short term. We evaluated S. pneumoniae carried in the nasopharynx before and after a round of azithromycin MDA to determine whether MDA was associated with changes in pneumococcal population structure. Methods: We ... Read more >>

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Impact of a single round of mass drug administration with azithromycin on active trachoma and ocular Chlamydia trachomatis prevalence and circulating strains in The Gambia and Senegal.

Emma M Harding-Esch, Martin J Holland, Jean-François Schémann, Ansumana Sillah, Boubacar Sarr, Linus Christerson, Harry Pickering, Sandra Molina-Gonzalez, Isatou Sarr, Aura A Andreasen, David Jeffries, Chris Grundy, David C W Mabey, Bjorn Herrmann, Robin L Bailey,

BACKGROUND:Mass drug administration (MDA) with azithromycin is a cornerstone of the trachoma elimination strategy. Although the global prevalence of active trachoma has declined considerably, prevalence persists or even increases in some communities and districts. To increase understanding of MDA impact, we investigated the prevalence of active trachoma and ocular C. ... Read more >>

Parasit Vectors (Parasites & vectors)
[2019, 12(1):497]

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Antibiotics for trachoma.

Jennifer R Evans, Anthony W Solomon, Rahul Kumar, Ángela Perez, Balendra P Singh, Rajat Mohan Srivastava, Emma Harding-Esch,

BACKGROUND:Trachoma is the world's leading infectious cause of blindness. In 1996, WHO launched the Alliance for the Global Elimination of Trachoma by the year 2020, based on the 'SAFE' strategy (surgery, antibiotics, facial cleanliness, and environmental improvement). OBJECTIVES:To assess the evidence supporting the antibiotic arm of the SAFE strategy by ... Read more >>

Cochrane Database Syst Rev (The Cochrane database of systematic reviews)
[2019, 9:CD001860]

Cited: 1 time

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Genotypic determinants of fluoroquinolone and macrolide resistance in Neisseria gonorrhoeae.

Catherine L Hall, Mark A Harrison, Marcus J Pond, Christine Chow, Emma M Harding-Esch, S Tariq Sadiq,

Background High rates of antimicrobial resistance (AMR) in Neisseria gonorrhoeae hinder effective treatment, but molecular AMR diagnostics may help address the challenge. This study aimed to appraise the literature for resistance-associated genotypic markers linked to fluoroquinolones and macrolides, to identify and review their use in diagnostics. METHODS:Medline and EMBASE databases ... Read more >>

Sex Health (Sexual health)
[2019, 16(5):479-487]

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The acceptability and utility of different diagnostic tests and sample types for the surveillance of trachoma in the Bijagos Islands, Guinea Bissau.

Ramandeep Sahota, Emma Harding-Esch,

Clin Med (Lond) (Clinical medicine (London, England))
[2019, 19(Suppl 3):93-93]

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"It's not a time spent issue, it's a 'what have you spent your time doing?' issue…" A qualitative study of UK patient opinions and expectations for implementation of Point of Care Tests for sexually transmitted infections and antimicrobial resistance.

Sebastian S Fuller, Agata Pacho, Claire E Broad, Achyuta V Nori, Emma M Harding-Esch, Syed Tariq Sadiq,

Sexually transmitted infections (STIs) continue to be a major public health concern in the United Kingdom (UK). Epidemiological models have shown that narrowing the time between STI diagnosis and treatment may reduce the population burden of infection, and rapid, accurate point-of-care tests (POCTs) have potential for increasing correct treatment and ... Read more >>

PLoS ONE (PloS one)
[2019, 14(4):e0215380]

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Impact of mass drug administration of azithromycin for trachoma elimination on prevalence and azithromycin resistance of genital Mycoplasma genitalium infection.

Mark Andrew Harrison, Emma Michele Harding-Esch, Michael Marks, Marcus James Pond, Robert Butcher, Anthony W Solomon, Liqing Zhou, NgeeKeong Tan, Achyuta V Nori, Henry Kako, Oliver Sokana, David C W Mabey, Syed Tariq Sadiq,

BACKGROUND:Mass drug administration (MDA) of 20 mg/kg (maximum 1 g in adults) azithromycin for ocular Chlamydia trachomatis (CT) infection is a key component of the WHO trachoma elimination strategy. However, this dose may be suboptimal in Mycoplasma genitalium infection and may encourage emergence of antimicrobial resistance (AMR) to azithromycin. OBJECTIVES:To ... Read more >>

Sex Transm Infect (Sexually transmitted infections)
[2019, 95(7):522-528]

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Completing Baseline Mapping of Trachoma in Uganda: Results of 14 Population-Based Prevalence Surveys Conducted in 2014 and 2018.

Gilbert Baayenda, Francis Mugume, Patrick Turyaguma, Edridah M Tukahebwa, Ben Binagwa, Ambrose Onapa, Stella Agunyo, Martin K Osilo, Michael D French, Wangeci Thuo, Lisa A Rotondo, Kristen Renneker, Rebecca Willis, Ana Bakhtiari, Emma M Harding-Esch, Anthony W Solomon, Jeremiah M Ngondi,

PURPOSE:We aimed to estimate the prevalence of trachomatous inflammation-follicular (TF) in children aged 1-9 years, trichiasis in adults aged ≥15 years, and water and sanitation (WASH) indicators in 12 suspected-endemic districts in Uganda. METHODS:Surveys were undertaken in 14 evaluation units (EUs) covering 12 districts. Districts were selected based on a desk review ... Read more >>

Ophthalmic Epidemiol (Ophthalmic epidemiology)
[2018, 25(sup1):162-170]

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Modelling-based evaluation of the costs, benefits and cost-effectiveness of multipathogen point-of-care tests for sexually transmitted infections in symptomatic genitourinary medicine clinic attendees.

Susie E Huntington, Richéal M Burns, Emma Harding-Esch, Michael J Harvey, Rachel Hill-Tout, Sebastian S Fuller, Elisabeth J Adams, S Tariq Sadiq,

OBJECTIVES:To quantify the costs, benefits and cost-effectiveness of three multipathogen point-of-care (POC) testing strategies for detecting common sexually transmitted infections (STIs) compared with standard laboratory testing. DESIGN:Modelling study. SETTING:Genitourinary medicine (GUM) services in England. POPULATION:A hypothetical cohort of 965 988 people, representing the annual number attending GUM services symptomatic of lower ... Read more >>

BMJ Open (BMJ open)
[2018, 8(9):e020394]

Cited: 1 time

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'Test n Treat (TnT)'- Rapid testing and same-day, on-site treatment to reduce rates of chlamydia in sexually active further education college students: study protocol for a cluster randomised feasibility trial.

Sarah Kerry-Barnard, Charlotte Fleming, Fiona Reid, Rachel Phillips, Vari M Drennan, Elisabeth J Adams, Wendy Majewska, Anjella Balendra, Emma Harding-Esch, Emma Cousins, S Tariq Sadiq, Pippa Oakeshott,

BACKGROUND:Sexually active young people attending London further education (FE) colleges have high rates of chlamydia, but screening rates are low. We will conduct a cluster randomised feasibility trial of frequent, rapid, on-site chlamydia testing and same-day treatment (Test and Treat (TnT)) in six FE colleges (with parallel qualitative and economic ... Read more >>

Trials (Trials)
[2018, 19(1):311]

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Health-related quality of life and psychosocial impacts of a diagnosis of non-specific genital infection in symptomatic heterosexual men attending UK sexual health clinics: a feasibility study.

Rachel Hill-Tout, Emma M Harding-Esch, Agata Pacho, Martina Furegato, Sebastian S Fuller, Syed Tariq Sadiq,

INTRODUCTION:Non-specific genital infection (NSGI; non-Chlamydia trachomatis, non-Neisseria gonorrhoeae-associated urethritis) is a common diagnosis in symptomatic heterosexual men attending UK sexual health clinics (SHCs). but little is known about the psychosocial impact of this diagnosis. METHODS:We conducted an observational study among symptomatic heterosexual men attending SHCs to evaluate the psychosocial impact ... Read more >>

BMJ Open (BMJ open)
[2018, 8(6):e018213]

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Detection of Chlamydia trachomatis in rectal specimens in women and its association with anal intercourse: a systematic review and meta-analysis.

Nastassya L Chandra, Claire Broad, Kate Folkard, Katy Town, Emma M Harding-Esch, Sarah C Woodhall, John M Saunders, S Tariq Sadiq, J Kevin Dunbar,

OBJECTIVES:Chlamydia trachomatis is the most commonly diagnosed bacterial STI. Lack of prevalence and risk factor data for rectal chlamydia in women has testing and treatment implications, as azithromycin (a first-line urogenital chlamydia treatment) may be less effective for rectal chlamydia. We conducted a systematic review of studies on women in ... Read more >>

Sex Transm Infect (Sexually transmitted infections)
[2018, 94(5):320-326]

Cited: 6 times

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The impact of a single round of community mass treatment with azithromycin on disease severity and ocular Chlamydia trachomatis load in treatment-naïve trachoma-endemic island communities in West Africa.

Anna R Last, Sarah E Burr, Emma Harding-Esch, Eunice Cassama, Meno Nabicassa, Chrissy H Roberts, David C W Mabey, Martin J Holland, Robin L Bailey,

Trachoma, a neglected tropical disease, is caused by ocular infection with Chlamydia trachomatis (Ct). The World Health Organization (WHO) recommends three annual rounds of community mass drug treatment with azithromycin (MDA) if the prevalence of follicular trachoma in 1-9 year olds (TF1-9) exceeds 10% at district level to achieve an ... Read more >>

Parasit Vectors (Parasites & vectors)
[2017, 10(1):624]

Cited: 4 times

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Using the eSexual Health Clinic to access chlamydia treatment and care via the internet: a qualitative interview study.

Catherine R H Aicken, Lorna J Sutcliffe, Jo Gibbs, Laura J Tickle, Kate Hone, Emma M Harding-Esch, Catherine H Mercer, Pam Sonnenberg, S Tariq Sadiq, Claudia S Estcourt, Maryam Shahmanesh,

OBJECTIVE:We developed the eSexual Health Clinic (eSHC), an innovative, complex clinical and public health intervention, embedded within a specialist sexual health service. Patients with genital chlamydia access their results online and are offered medical management via an automated online clinical consultation, leading to antibiotic collection from community pharmacy. A telephone ... Read more >>

Sex Transm Infect (Sexually transmitted infections)
[2018, 94(4):241-247]

Cited: 3 times

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Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal.

Emma M Harding-Esch, Julbert Kadimpeul, Boubacar Sarr, Awa Sane, Souleymane Badji, Mass Laye, Ansumana Sillah, Sarah E Burr, David MacLeod, Anna R Last, Martin J Holland, David C Mabey, Robin L Bailey,

Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. We conducted the first population-based trachoma prevalence survey in the Casamance region of Senegal to enable the Senegalese National Eye Care Programme (NECP) to plan its trachoma control activities. The World Health Organization (WHO) ... Read more >>

BMC Public Health (BMC public health)
[2017, 18(1):62]

Cited: 4 times

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Short-term increase in prevalence of nasopharyngeal carriage of macrolide-resistant Staphylococcus aureus following mass drug administration with azithromycin for trachoma control.

Ebrima Bojang, James Jafali, Vincent Perreten, John Hart, Emma M Harding-Esch, Ansumana Sillah, David C W Mabey, Martin J Holland, Robin L Bailey, Anna Roca, Sarah E Burr,

Mass drug administration (MDA) with azithromycin is a corner-stone of trachoma control however it may drive the emergence of antimicrobial resistance. In a cluster-randomized trial (Clinical trial gov NCT00792922), we compared the reduction in the prevalence of active trachoma in communities that received three annual rounds of MDA to that ... Read more >>

BMC Microbiol. (BMC microbiology)
[2017, 17(1):75]

Cited: 5 times

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Spatial clustering of high load ocular Chlamydia trachomatis infection in trachoma: a cross-sectional population-based study.

Anna Last, Sarah Burr, Neal Alexander, Emma Harding-Esch, Chrissy H Roberts, Meno Nabicassa, Eunice Teixeira da Silva Cassama, David Mabey, Martin Holland, Robin Bailey,

Chlamydia trachomatis (Ct) is the most common cause of bacterial sexually transmitted infection and infectious cause of blindness (trachoma) worldwide. Understanding the spatial distribution of Ct infection may enable us to identify populations at risk and improve our understanding of Ct transmission. In this study, we sought to investigate the ... Read more >>

Pathog Dis (Pathogens and disease)
[2017, 75(5):]

Cited: 2 times

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The eSexual Health Clinic system for management, prevention, and control of sexually transmitted infections: exploratory studies in people testing for Chlamydia trachomatis.

Claudia S Estcourt, Jo Gibbs, Lorna J Sutcliffe, Voula Gkatzidou, Laura Tickle, Kate Hone, Catherine Aicken, Catherine M Lowndes, Emma M Harding-Esch, Sue Eaton, Pippa Oakeshott, Ala Szczepura, Richard E Ashcroft, Andrew Copas, Anthony Nettleship, S Tariq Sadiq, Pam Sonnenberg,

Self-directed and internet-based care are key elements of eHealth agendas. We developed a complex online clinical and public health intervention, the eSexual Health Clinic (eSHC), in which patients with genital chlamydia are diagnosed and medically managed via an automated online clinical consultation, leading to antibiotic collection from a pharmacy. Partner ... Read more >>

Lancet Public Health (The Lancet. Public health)
[2017, 2(4):e182-e190]

Cited: 10 times

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Impact of deploying multiple point-of-care tests with a 'sample first' approach on a sexual health clinical care pathway. A service evaluation.

Emma M Harding-Esch, Achyuta V Nori, Aseel Hegazi, Marcus J Pond, Olanike Okolo, Anthony Nardone, Catherine M Lowndes, Phillip Hay, S Tariq Sadiq,

To assess clinical service value of STI point-of-care test (POCT) use in a 'sample first' clinical pathway (patients providing samples on arrival at clinic, before clinician consultation). Specific outcomes were: patient acceptability; whether a rapid nucleic acid amplification test (NAAT) for Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG) could be used as a ... Read more >>

Sex Transm Infect (Sexually transmitted infections)
[2017, 93(6):424-429]

Cited: 7 times

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Self-sampling and self-testing for STIs and HIV: the case for consistent nomenclature.

Emma M Harding-Esch, Emma Hollis, Hamish Mohammed, John M Saunders,

Sex Transm Infect (Sexually transmitted infections)
[2017, 93(2):445-448]

Cited: 10 times

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The eClinical Care Pathway Framework: a novel structure for creation of online complex clinical care pathways and its application in the management of sexually transmitted infections.

Jo Gibbs, Lorna J Sutcliffe, Voula Gkatzidou, Kate Hone, Richard E Ashcroft, Emma M Harding-Esch, Catherine M Lowndes, S Tariq Sadiq, Pam Sonnenberg, Claudia S Estcourt,

Despite considerable international eHealth impetus, there is no guidance on the development of online clinical care pathways. Advances in diagnostics now enable self-testing with home diagnosis, to which comprehensive online clinical care could be linked, facilitating completely self-directed, remote care. We describe a new framework for developing complex online clinical ... Read more >>

BMC Med Inform Decis Mak (BMC medical informatics and decision making)
[2016, 16:98]

Cited: 6 times

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Cross-Sectional Surveys of the Prevalence of Follicular Trachoma and Trichiasis in The Gambia: Has Elimination Been Reached?

Sarah E Burr, Ansumana Sillah, Anselme S Sanou, Anita C Wadagni, John Hart, Emma M Harding-Esch, Sarjo Kanyi, Robin L Bailey,

BACKGROUND:The Gambia's National Eye Health Programme has made a concerted effort to reduce the prevalence of trachoma. The present study had two objectives. The first was to conduct surveillance following mass drug administrations to determine whether The Gambia has reached the World Health Organization's (WHO) criteria for trachoma elimination, namely ... Read more >>

PLoS Negl Trop Dis (PLoS neglected tropical diseases)
[2016, 10(9):e0004906]

Cited: 3 times

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Accurate detection of Neisseria gonorrhoeae ciprofloxacin susceptibility directly from genital and extragenital clinical samples: towards genotype-guided antimicrobial therapy.

Marcus J Pond, Catherine L Hall, Victoria F Miari, Michelle Cole, Ken G Laing, Heena Jagatia, Emma Harding-Esch, Irene M Monahan, Timothy Planche, Jason Hinds, Catherine A Ison, Stephanie Chisholm, Philip D Butcher, Syed Tariq Sadiq,

Increasing use of nucleic acid amplification tests (NAATs) as the primary means of diagnosing gonococcal infection has resulted in diminished availability of Neisseria gonorrhoeae antimicrobial susceptibility data. We conducted a prospective diagnostic assessment of a real-time PCR assay (NGSNP) enabling direct detection of gonococcal ciprofloxacin susceptibility from a range of ... Read more >>

J. Antimicrob. Chemother. (The Journal of antimicrobial chemotherapy)
[2016, 71(4):897-902]

Cited: 15 times

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