Systematic literature review on the effects of asymptomatic testing for Chlamydia trachomatis and Neisseria gonorrhoeae

Across the EU/EEA, testing for Chlamydia trachomatis and Neisseria gonorrhoeae is a central component of sexually transmitted infection (STI) prevention and control strategies. While testing of symptomatic individuals is standard clinical practice, the role of asymptomatic testing as a population-level public health intervention varies across countries and population groups. Existing European and international guidelines recommend asymptomatic testing for selected populations, including young people, men who have sex with men, and individuals at higher risk of exposure. However, recommendations differ in terms of target populations, testing frequency, and implementation approaches, and are often adapted to national epidemiological contexts. As a result, substantial heterogeneity exists across EU/EEA countries in asymptomatic testing policies. As reminded in the Request for Services, in recent years, the public health value of widespread asymptomatic testing has been increasingly questioned. Several EU/EEA countries have consequently revised or are currently reviewing their testing strategies, reflecting evolving interpretations of the available evidence. Both the EU/EEA STI network and the ECDC Advisory Forum have highlighted the need for updated evidence-based guidance to support policy decision-making on asymptomatic testing in the European context. The objective of this systematic review is to generate a robust and policy-relevant evidence base on the effects of asymptomatic testing for C. trachomatis and N. gonorrhoeae in EU/EEA-relevant populations. The findings will inform the development of ECDC recommendations on asymptomatic testing, to support the formulation of policy guidance adapted to EU/EEA settings.