World Health Organization Laboratory Research Articles

Improving the Laboratory Investigation Price Revising Process at Sri Jayawardhanapura General Hospital

Sri Jayawardhanapura General Hospital (SJGH) is a non-profit public enterprise that offers reasonable services. The hospital relies on government grants and revenue generated by patient care services for funding. One of its crucial departments is a laboratory, which serves as a vital support service and the main profit center. However, the frequent rise of consumable prices during economic crises significantly impacts the variable costs of laboratory tests, resulting in financial losses.Calculating the cost incurred by laboratory investigations is essential for implementing a price revision strategy to address this issue. Given the absence of a recognized method for calculating investigation costs, adopting the World Health Organization's Laboratory Test Costing Tool (LTCT), a user-friendly Microsoft Excel-based tool, is recommended. This tool is specifically designed to assist in calculating laboratory test costs, ensuring a more accurate understanding of expenses incurred.Additionally, establishing key indicators to signal the need for price revision and assigning responsibility to initiate the price revision process when these indicators are triggered will streamline the process and improve its responsiveness to financial challenges. By employing such a system, SJGJ can better manage its laboratory costs, maintain service quality, and ensure sustainable operations even during economic hardships.

Sixth edition of the World Health Organization laboratory manual of semen analysis: Updates and essential take away for busy clinicians

ABSTRACT Background Semen analysis is the cornerstone for male fertility evaluation. In 2021, the World Health Organization (WHO) released its 6th edition of semen analysis manual. Methods We highlight the main changes in the latest 6th edition of the WHO manual of semen analysis and their possible interpretations. Results The manual is highly comprehensive, offering detailed information, and is widely regarded as an excellent technical reference for laboratory staff. Nevertheless, several aspects of the manual require further elucidation for infertility practitioners. Conclusion The recently published 6th edition of the WHO manual provides a strong framework for the assessment and processing of human semen. Grasping the modifications introduced in this updated edition and their clinical significance can enhance the quality of patient care.

Managing Risk When Working with Orbiviruses with a Special Emphasis on Epizootic Hemorrhagic Disease Virus.

Risk assessment is the cornerstone of working safely with biological agents. The World Health Organization (WHO) Laboratory Biosafety Manual Fourth Edition Monograph on Risk Assessment provides stepwise guidance for completing a risk assessment, from information gathering and identifying hazards to evaluating the risks, developing, and implementing controls and review.To support the development of a mature safety culture within laboratories, it is important that all staff who handle biological agents understand the fundamentals of risk assessment and receive training in identifying hazards created by their work activities (or tasks) and understand how to mitigate the risks arising from carrying out that work. Any "competent" person may be involved in assessing the risks posed by carrying out an activity. Those closest to the work, who understand the details of the task being undertaken, should be involved in creating the risk assessment. The guidance in this chapter is not just applicable to biosafety professionals, laboratory scientists, or facility managers but can be used by any competent worker familiar with the activity being assessed.This chapter uses the guidance from the WHO to apply the principles of risk assessment to working with Epizootic hemorrhagic disease virus (EHDV), using an example activity-virus isolation from EHDV test samples in cell culture.

Androloji laboratuvarlarında semen analizi standardizasyonun Dünya Sağlık Örgütü (DSÖ) kriterlerine göre değerlendirilmesi

OBJECTIVE: Due to its complexity and subjectivity, semen analysis is difficult to standardize across laboratories. Our aim in this study is to collect basic information about semen analysis of andrology laboratories in Türkiye and to determine the level of standardization within and between laboratories for semen analysis. MATERIAL and METHODS: A survey consisting of 41 questions covering all aspects of semen analysis was sent to 145 andrology laboratories that perform semen analysis in Türkiye. Of all, 106 laboratories filled out and returned the survey. The content of the survey was prepared according to the procedures specified in the 6th edition of the 2021 World Health Organization (WHO) laboratory handbook for the examination and processing of human semen. The survey was designed to obtain information about the reported parameters, semen collection and storage, macroscopic-microscopic evaluation, advanced tests and internal-external quality control of the laboratory. RESULTS: In relation to the laboratories, 84.1% of the parameters reported in semen analysis, 75.8% of the semen collection phase, 76.5% of the storage of semen in the laboratory and macroscopic analysis, 78.07% of the microscopic analysis of semen, 49.8% of advanced tests and 73% of the parameters related to quality criteria were compatible with WHO 2021 criteria. CONCLUSION: There appear to be differences between laboratories in Türkiye in the reporting and standardization of semen analysis according to the WHO 2021 criteria. Many different standards and criteria are used for semen analysis in andrology laboratories. This makes it difficult to compare results from one laboratory to another. Therefore, it should be recommended that semen analysis be evaluated according to the criteria set by international standards and guidelines. Keywords: semen analysis, andrology laboratory, microscopic analysis

Contemporary challenges and advanced technologies in the management of subfertile men with varicocele.

Varicocele, closely linked to male fertility, requires urgent and focused research due to many unresolved questions. The absence of clear reference values distinguishing "normal" from "abnormal" semen parameters in the 6th World Health Organization (WHO) laboratory manual significantly complicates diagnosis and treatment. Additionally, the clinical relevance of total progressively motile sperm count (TMSC) remains unclear, leaving practitioners without critical guidance. The decision to perform varicocelectomy, particularly in cases of isolated teratozoospermia, is fraught with uncertainty. Furthermore, the best treatment strategy for those experiencing subfertility after varicocele surgery is still undetermined, adding another layer of complexity. These pressing issues, along with contentious debates surrounding isolated teratozoospermia treatment, highlight the need for large-scale multicenter randomized clinical trials. Such studies are essential to fully understand varicocele's impact on male fertility and to develop evidence-based management protocols.

The effect of various air pollution and participants' age on semen quality in southern Taiwan

ObjectiveThis study aimed to investigate the association between semen quality and air pollution in southern Taiwan. Materials and methodsIn this retrospective study, 4338 males aged 21–70 years were recruited between 2001 and 2018 from a reproductive medical center. Semen quality was assessed according to standardized methods outlined in the World Health Organization (WHO) Laboratory Manual 1999 and 2010, including total sperm count, progressive sperm motility (%), rapid progressive sperm motility (%), and sperm with normal morphology (%). All designated national air quality automatic continuous monitoring stations measured the levels of air pollution [particulate matter (PM10 and PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3)], and was documented by Environmental Protection Administration in Taiwan. We collected data on the levels of air pollution based on the participants' residential addresses. ResultsIn our study, we found that progressive and rapid progressive sperm motility significantly decreased annually (p < 0.05). In addition, increasing age influenced total sperm count, progressive sperm motility, rapid progressive sperm motility, and sperm with normal morphology (p < 0.05). Among different air pollution, we observed SO2 was associated with lower rapid progressive sperm motility and lower sperm with normal morphology (β = −0.103, p = 0.043; β = 0.118, p = 0.001, respectively). However, NO2 was associated with higher rapid progressive sperm motility and a high number of sperm with normal morphology (β = 0.129, p = 0.002; β = 0.127, p < 0.001, respectively). ConclusionsThe semen quality in southern Taiwan appears to have declined in recent years. The participant's age for semen analysis was most strongly associated with semen parameters, Moreover, a significant association between SO2 and NO2 levels and semen motility was observed, even after adjusting for multiple comparisons. Further study is required to analyze the dose-dependent effect of SO2 and NO2 on semen parameters.

O-285 The 6th edition of the WHO manual for the examination and processing of human semen: How should it affect our practice?

Abstract The WHO laboratory manual (World Health Organization 2021) has widened the scope of semen examination from primarily a prognostic tool for Medically Assisted Reproduction (MAR) by indicating the importance of evaluating men with possible disorders in male reproductive functions. Practical instructions for basic examination have been clarified and focused to measures of sperm production and motility as judged from sperm number, motility (vitality if poor motility) and sperm morphology. In addition to the recommendations by the WHO, an international standard based on the same laboratory science as the WHO manual has been published (International Organization for Standardization 2021) to facilitate for laboratories to provide reliable results of semen examination. Each ejaculate must be handled with great care before analysis begins. Time and temperature between sample collection and start of assessments is crucial. To reduce assessment variability, it is essential to ascertain that the examined aliquots are representative for the entire ejaculate and that the number of observations is sufficient to reduce the risk for significant influence of random factors. The former is handled both by aliquot volume (at least 50 µL for sperm concentration) and replicate assessment and comparison that the two assessments don’t differ too much. Regarding number of observations, 400 sperm counted in sperm concentration and in sperm motility assessments is required to reduce this source of errors to ± 10%. For assessment of sperm morphology and vitality a minimum number of observations is 200 spermatozoa. To achieve acceptable performance, thorough in-house training is necessary. There are protocols how to set up and run such schemes (Mortimer 1994, 1994). Basic medical laboratory standards also require that the laboratory regularly performs internal quality control to monitor that inter- and intra-personal variability is under control. Each laboratory should also participate in an external scheme for quality assessment (EQA) (International Organization for Standardization 2012). For the proper interpretation of semen examination results reference limits are important. However, the reference limits suggested by the WHO (World Health Organization 2021) come from a very mixed group of men and should therefore not be mistaken for true limits between fertility and infertility. The new WHO manual therefore argues for development of decision limits (when is it reasonable to act?) that are much more important than limits from a mixed population. It has been argued that semen examination must be better standardized (Björndahl et al. 2016), but the compliance has been almost non-existent (Vasconcelos et al. 2022) leading to even stronger appeals for stronger improvement of basic laboratory investigations of male reproductive functions (Björndahl et al. 2022) References Björndahl L, Barratt CL, Mortimer D, and Jouannet P. ‘How to count sperm properly': checklist for acceptability of studies based on human semen analysis. Hum Reprod 2016: 31; 227-232. Björndahl L, Barratt CLR, Mortimer D, Agarwal A, Aitken RJ, Alvarez JG, Aneck-Hahn N, Arver S, Baldi E, Bassas L, et al. Standards in semen examination: publishing reproducible and reliable data based on high-quality methodology. Hum Reprod 2022. International Organization for Standardization. ISO 15189:2012 Medical Laboratories – Requirements for Quality and Competence 2012. Geneva. International Organization for Standardization. ISO 23162:2021 Basic semen examination — Specification and test methods 2021. ISO, Geneva. Mortimer D. Laboratory standards in routine clinical andrology. Reproductive Medicine Review 1994: 3; 97-111. Mortimer D. Practical Laboratory Andrology 1994. Oxford University Press, Oxford. Vasconcelos AL, Campbell MJ, Barratt CLR, and Gellatly SA. Do studies published in two leading reproduction journals between 2011 and 2020 demonstrate that they followed WHO5 recommendations for basic semen analysis? Hum Reprod 2022. World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th edn, 2021. World Health Organization, Geneva.

Association between central obesity and semen quality: A cross-sectional study in 4513 Chinese sperm donation volunteers.

General obesity classified by body mass index has been linked to a reduction in semen quality; however, evidence on the adverse effect of central obesity on semen quality remains limited. To investigate the association between central obesity and semen quality. We conducted a cross-sectional study of 4513 sperm donation volunteers in Guangdong Provincial Human Sperm Bank during 2018-2021. Three central obesity indicators, including waist circumference, waist-to-hip ratio, and waist-to-height ratio, were measured using a multi-frequency bioelectrical impedance analysis for each subject. Semen analysis was conducted according to the World Health Organization laboratory manual for the examination and processing of human semen 5th edition. Linear regression models and unconditional logistic regression models were used to quantify the association between central obesity and semen parameters. With adjustment for age, race, education level, marital status, fertility status, occupation, year of semen collection, abstinence period, ambient temperature, and relative humidity, central obesity defined as waist circumference ≥90cm, waist-to-hip ratio ≥0.9, or waist-to-height ratio ≥0.5 was significantly associated with a 0.27 (95% confidence interval: 0.15, 0.38) mL, 14.47 (3.60, 25.34) × 106 , 7.06 (0.46, 13.76)× 106 , and 6.80 (0.42, 13.18) × 106 reduction in semen volume, total sperm number, total motile sperm number, and total progressive motile sperm number, respectively, and a 53% (10%, 112%) increase in odds of below the World Health Organization 2010 reference value for semen volume. These associations did not significantly vary across age. Similar results were observed for central obesity defined using each of the three indicators, except that subjects with a waist circumference ≥90cm had a slightly higher total motility (estimated change: 1.30%; 95% confidence interval: 0.27%, 2.34%) and progressive motility (estimated change: 1.27%; 95% confidence interval: 0.23%, 2.31%). We found that central obesity was significantly associated with a reduction in semen volume, total sperm number, total motile sperm number, and total progressive motile sperm number. Future studies are warranted to confirm our results in other regions and populations.

Sperm concentrations do not correlate with semen parameters and hormone profiles in males recovered from COVID-19.

Although the negative impact on fertility of men recovered from coronavirus disease 2019 (COVID-19) has been suggested, there is insufficient evidence, and the data are limited and contradictory. The present prospective study aimed to evaluate the sex-related hormones, semen parameters, erectile dysfunction (ED), and lower urinary tract symptoms (LUTS) in a cohort of men who recovered from COVID-19 and age-matched control men. Semen samples were collected from twenty-two men recovered from COVID-19 with a median time of 91.5 days and thirty-six control males. The semen parameters were evaluated according to the World Health Organization (WHO) laboratory manual to examine and process human semen. The blood samples were collected to assess the male hormone profile. ED and LUTS were evaluated with the International Index of Erectile Function 5 (IIEF-5) and the International Prostate Symptom Score (IPSS), respectively. The follicle-stimulating hormone (FSH) (3.819±1.515 IU/L), luteinizing hormone (LH) (4.023±1.792 IU/L), prolactin (PRL) [12.60 (10.72-15.20) ng/mL], and testosterone (T) [4.345 (3.565-5.525) ng/mL] levels were at normal range in all males enrolled in the study. Levels of semen volume (control: 2.5 mL vs. COVID-19: 1.9 mL; P<0.05) and sperm concentration (control: 59×106/mL vs. COVID-19: 41.5×106/mL; P<0.005) were significantly lower in males recovered from COVID-19, but still technically well within normal regardless of WHO edition. All variables were examined through logistic regression analysis, demonstrating that only sperm concentration was an independent variable associated with men recovered from COVID-19 [odds ratio (OR) =1; 95% confidence interval (CI): 0.999-1.098; P=0.016]. According to correlation analysis, there was no correlation between sperm concentration and other semen parameters and sex-related hormone profiles. Furthermore, an absence of ED and LUTS in men who recovered from COVID-19 was evidenced using the IIEF-5 and IPSS, respectively. Reproductive-age males recovered from COVID-19 have normal sperm concentration. Sperm concentration did not correlate with other semen parameters, sex-related hormones, IIEF-5, and IPSS. Further studies should be performed to evaluate whether the lower sperm concentration and semen volume that were still within the normal range are a transient or prolonged downregulation resulting from the COVID-19 attack.

Dietary total antioxidant capacity and the risk of developing asthenozoospermia: a hospital-based case-control study in China.

Is dietary total antioxidant capacity (DTAC) associated with the odds of developing asthenozoospermia in Chinese men? There is no statistically significant association between DTAC indices and the odds of developing asthenozoospermia. Both diet and oxidative stress may be related to sperm quality; however, few studies have investigated the association between DTAC and sperm quality. This case-control study was conducted from June 2020 to December 2020. Those diagnosed with asthenozoospermia were assigned to the case group, whereas those with normal sperm parameters were assigned to the control group. Data from a total of 553 cases and 586 controls were included in the final analysis. Men who had been referred to the infertility clinic of Shengjing Hospital of China Medical University were enrolled. Dietary intake was assessed using a validated food frequency questionnaire. DTAC was based on ferric-reducing ability of plasma (FRAP), total oxygen radical absorbance capacity (T-ORAC), hydrophilic oxygen radical absorbance capacity (H-ORAC), lipophilic oxygen radical absorbance capacity (L-ORAC), total phenolics (TP), total radical-trapping antioxidant parameter (TRAP), and Trolox equivalent antioxidant capacity (TEAC). Asthenozoospermia was defined according to the criteria published in the fifth edition of the World Health Organization laboratory manual for the examination and processing of human semen. No significant association was observed between the DTAC indices and the odds of asthenozoospermia after multivariable adjustment (T3 vs T1, odds ratio (OR) = 0.99, 95% CI: 0.73-1.33 for FRAP; OR = 1.05, 95% CI: 0.77-1.42 for T-ORAC; OR = 0.88, 95% CI: 0.65-1.18 for H-ORAC; OR = 0.98, 95% CI: 0.71-1.34 for L-ORAC; OR = 1.03, 95% CI: 0.76-1.39 for TP; OR = 1.18, 95% CI: 0.87-1.59 for TRAP; and OR = 1.15, 95% CI: 0.85-1.55 for TEAC). Both additive and multiplicative interaction analyses suggested that smoking might modify the association of T-ORAC with the odds of developing asthenozoospermia (relative excess risk due to interaction = 0.45, 95% CI: 0.07-0.83, attributable proportion due to interaction = 0.46, 95% CI: 0.07-0.84 for additive interaction; P = 0.033 for multiplicative interaction). Recall bias and protopathic bias were inevitable in this retrospective case-control study. The estimation accuracy of the DTAC indices may have also affected the findings. To the best of our knowledge, this is the first study to specifically investigate whether an association exists between DTAC and the odds of developing asthenozoospermia. Although no significant association was found, this study provides novel information pertaining to the fields of nutrition and human reproduction. This work was supported by the JieBangGuaShuai Project of Liaoning Province (2021JH1/10400050), the Shengjing Hospital Clinical Research Project (M0071), and the Outstanding Scientific Fund of Shengjing Hospital (M1150). All authors have no competing interests to disclose. N/A.

Assessment of laboratory capacity in conflict-affected low-resource settings using two World Health Organization laboratory assessment tools.

Laboratory diagnostic services are essential to drive evidence-based treatment decisions, manage outbreaks, and provide population-level data. Many low- and middle-income countries (LMICs) lack sufficient diagnostic capacity, often further exacerbated in conflict-affected areas. This project assessed laboratory services in conflict-affected LMICs to understand gaps and opportunities for improving laboratory capacity. The World Health Organization Laboratory Assessment Tool Facility Questionnaire (WHO Laboratory Tool) and Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) checklist were used to assess five laboratories in Eastern Democratic Republic of the Congo (DRC) and five in Gaza, Palestine. Total scores and percentage outcomes by indicator were calculated. Average WHO Laboratory Tool score across all facilities was 41% (range 32-50%) in DRC and 78% (range 72-84%) in Gaza. Lowest scoring indicators in DRC were Biorisk management (13%, range 8-21%), Documentation (14%, range 6-21%), and in Gaza, were Facilities (59%, range 46-75%) and Documentation (60%, range 44-76%). Highest scoring indicators in DRC were Facilities (70%, range 45-83%) and Data and Information Management (61%, range 38-80%), and in Gaza were Data Information and Management (96%) and Public Health Function (91%, range 88-94%). In DRC, no laboratory achieved a SLIPTA star rating. In Gaza, two laboratories had a 3-star SLIPTA rating, one had a 2-star rating and two had a 1-star rating. Laboratory systems in conflict-affected LMICs have significant gaps. Implementating improvement strategies in such settings may be especially challenging.

Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.

Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians.

The association between healthy eating index score with semen parameters in infertile men: A cross-sectional study.

Infertility has been a major problem for young couples in recent years. One way to assay the diet quality is the healthy eating index (HEI), related to infertility. This study aims to assess the association between the HEI score with semen parameters in Iranian infertile men. Two hundred and sixty eligible men (18-55 yr), were referred to the major infertility clinic in the summer of 2018 and entered this cross-sectional study. Based on the 5 edition of the world health organization laboratory manual, semen parameters including sperm concentration, volume, motility, and morphology were analyzed, and to specify the dietary intake of individuals a 168-item questionnaire was used. Also, to calculate the total HEI score, all 13 components based on HEI-2015 components and scoring standards were summed up. Participants in the highest tertile, had no difference in mean sperm parameters with those in the lowest tertile in the crude model. No significant association was found between sperm parameters and HEI score tertiles in the crude model, even after adjustment for potential confounders, except for concentration (OR: 0.39 and CI: 0.15, 0.99, p = 0.04). Participants in the highest tertile had a lower risk of abnormal concentration and motility in the crude model. The risk of abnormal concentration decreased, and motility increased in the adjusted model. In this cross-sectional study, there was no significant relationship between HEI and sperm indexes, except for sperm concentration. Therefore, more studies need to be done in the future.

Strengthening Biorisk Management Capacities in Burkina Faso: Contribution of the Global Health Security Agenda.

The Global Health Security Agenda and the International Health Regulations (2005) recommend that countries strengthen the capacity of their national laboratory systems to comply with the International Health Regulations. To efficiently and effectively direct these efforts, the US Centers for Disease Control and Prevention-in collaboration with the Ministry of Health Directorate of Laboratories, the African Society for Laboratory Medicine, and Integrated Quality Laboratory Service-assessed Burkina Faso's national laboratory system using the World Health Organization Laboratory Assessment Tool. Based on gaps observed in biorisk management, the Biosafety and Biosecurity Laboratory Assessment Tool (BSS LAT) was developed to assess 10 public laboratories handling dangerous pathogens. This tool uses a specific scoring matrix with quantitative output. Composite assessment scores for the 9 primary modules (capacity areas) were reported, with the highest scores reported in cleaning, disinfection, sterilization, waste management (42%), and good laboratory practices (40%), and the lowest scores in biosecurity/biosafety (33%), documents/regulations (18%), emergency management (16%), and risk management (5%). To address challenges identified in the assessments, a set of activities was planned with a focus on biorisk management. Results from an evaluation conducted 1 year later, using the BSS LAT, showed an increase in the average score of all indicators from 25% to 45% and an increase in the biorisk management module score from 5% to 35%. This evaluation process was a decisive step toward strengthening the capacity of the laboratory system in Burkina Faso. Global Health Security Agenda investments and activities have made a lasting impact on improving biosafety and biosecurity in public health laboratories. To ensure sustainability, a strong laboratory quality management program based on a mentorship system is greatly needed.

Effect of Radiofrequency Electromagnetic Radiation Emitted by Modern Cellphones on Sperm Motility and Viability: An In Vitro Study

BackgroundCellphones emit radiofrequency electromagnetic radiation (RF-EMR) for transmission of data for social media communication, web browsing, and music/podcast streaming. Use of Bluetooth ear buds has probably prolonged the time during which cellphones reside in the trouser pockets of men. It has been postulated that RF-EMR increases oxidative stress and induces free radical formation. ObjectiveTo investigate the effect of wireless-spectrum (4G, 5G, and WiFi) RF-EMR emitted by modern smartphones on sperm motility and viability and explore whether these effects can be mitigated using a physical barrier or distance. Design, setting, and participantsSemen samples were obtained from fertile normozoospermic men aged 25–35 yr. A current-generation smartphone in talk mode was used as the RF-EMR source. A WhatsApp voice call was made using either 4G, 5G, or WiFi wireless connectivity. We determined if exposure effects were mitigated by either a cellphone case or greater distance from the semen sample. Outcome measurements and statistical analysisThe semen samples were analyzed according to 2010 World Health Organization laboratory guidelines. Statistical analysis was performed using SPSS v.28. Results and limitationsWe observed decreases in sperm motility and viability with WiFi exposure but not with exposure to 4G or 5G RF-EMR. With large variability among smartphones, continued research on exposure effects is needed. ConclusionsOur exploratory study revealed that sperm motility and viability are negatively impacted by smartphones that use the WiFi spectrum for data transmission. Patient summaryWe looked at the effect of cellphone use on sperm motility and viability. We found that cellphones using WiFi connectivity for data usage have harmful effects on semen quality in men.

WHO Non-Lab-Based CVD Risk Assessment: A Reliable Measure in a North Indian Population.

Introduction:Timely, affordable, and sustained interventions reduce the risk of heart attack or Stroke in people with a high total risk of cardiovascular diseases (CVD). Risk prediction tools are available to estimate the cardiovascular risk using information on multiple variables. CVD risk charts prepared by the World Health Organization (WHO) has laboratory-based and non-laboratory-based charts with the latter meant for use in resource limited settings. We conducted a study to determine concordance between the laboratory- and non-laboratory risk charts and to estimate the prevalence of selected CVD risk factors in a rural Indian population.Methods:A community-based cross-sectional study was conducted in rural area of Ballabgarh in district Faridabad, Haryana. Sample of 1,018 participants aged 30–69 years was selected randomly from study area. Information on CVDs risk factors was obtained using WHO STEPS questionnaire, anthropometry and laboratory investigation. Risk distribution among the study participants was observed. Concordance between laboratory- and non-laboratory-based WHO CVD risk charts was determined using agreement analysis.Results:The mean age of the study participants was 43.9 (8.9) years and 55.6% participants were women. Among various CVD risk factors, hypertension (39.4%) was the major factor followed by overweight (34.1%) was found to be major factor, followed by current smoking (23.6%) and hypercholesterolemia (18.7%). The concordance between the two charts was 83.3% with kappa value of 0.64. Considering laboratory-based charts as the gold standard, the sensitivity and specificity of non-laboratory-based risk charts at 5% risk as cut-off was 86.5% and 90.3% respectively.Conclusion:The study shows a good agreement between the laboratory-based and non-laboratory-based risk charts. Thus non-laboratory-based risk charts are suitable for risk estimation of CVDs for use in resource limited settings like India.

Do studies published in two leading reproduction journals between 2011 and 2020 demonstrate that they followed WHO5 recommendations for basic semen analysis?

STUDY QUESTIONDo publications that involve the interpretation of the results of a basic semen analysis, published in Human Reproduction and Fertility & Sterility between 2011 and 2020, give sufficient evidence in their methodology to demonstrate that they followed the technical methods recommended in the fifth edition of the World Health Organization (WHO) laboratory manual, entitled WHO Laboratory Manual for the Examination and Processing of Human Semen (WHO5)?SUMMARY ANSWEREvidence of methodological agreement of studies with the WHO5 recommendations was low, despite 70% of papers stating that they followed WHO5 recommendations.WHAT IS KNOWN ALREADYA basic semen analysis is currently an integral part of infertility investigations of the male, but method standardization in laboratories remains an issue. The different editions of the WHO manual for the basic semen analysis (WHO1–6) have attempted to address this by providing increasingly rigorous methodological protocols to reduce experimental error. However, to what extent these methods are followed by studies that involve the interpretation of the results of basic semen analysis remains unknown.STUDY DESIGN, SIZE, DURATIONA survey of the technical methods used to perform a basic semen analysis was conducted on studies published in two leading reproduction journals (Human Reproduction and Fertility & Sterility) between 2011 and 2020.PARTICIPANTS/MATERIALS, SETTING, METHODSThe literature search was performed on the electronic databases PUBMED and MEDLINE Ovid between January 2021 and March 2021. The MeSH terms included in the search were ‘sperm concentration’ OR ‘sperm motility’ OR ‘sperm morphology’ OR ‘sperm vitality’ OR ‘male fertility’ AND ‘human spermatozoa’ NOT ‘animals’. A total of 122 studies were available for analysis.MAIN RESULTS AND THE ROLE OF CHANCEIn total, 70% of the studies cited WHO5 in their methods section. Of the remaining studies, 10% cited the fourth edition of the WHO laboratory manual (WHO4), 7% cited both WHO4 and WHO5, 1% cited the third edition of the WHO laboratory manual (WHO3), and 12% did not cite the WHO at all. Overall methodological agreement with WHO5 recommendations was poor, with the main reason for this lack of agreement being that the research studies did not disclose specific details of the technical methods and equipment used.LIMITATIONS, REASONS FOR CAUTIONIn the case of studies that did not disclose any specific technical methods that they used, we did not attempt to contact these authors and so were unable to confirm the agreement between their technical methods and WHO5 recommendations.WIDER IMPLICATIONS OF THE FINDINGSOur findings suggest there is an urgent need to develop strategies to address standardization in reporting the results of a semen analysis for publication. This is particularly timely given the recent publication of WHO6 and ISO standard 23162 for the basic examination of human semen.STUDY FUNDING/COMPETING INTEREST(S)There was no funding for this project. C.L.R.B., as an employee of the University of Dundee, serves on the Scientific Advisory board of ExSeed Health (from October 2021, financial compensation to the University of Dundee) and is a scientific consultant for Exscientia (from September 2021, financial compensation to the University of Dundee). C.L.R.B. has previously received a fee from Cooper Surgical for lectures on scientific research methods outside the submitted work (2020) and Ferring for a lecture on male reproductive health (2021). C.L.R.B. is Editor for RBMO.TRIAL REGISTRATION NUMBERN/A.

Laboratory evaluation of a new alphacypermethrin long-lasting insecticidal net against Anopheles culicifacies s.l.

Long-lasting insecticidal nets (LLINs) are being promoted by World Health Organization (WHO) as key vector control tool for the prevention and control of malaria and other vector-borne diseases. A laboratory study was conducted to evaluate the bio-efficacy of a new alphacypermethrin LN (HILNET®) against insecticide-susceptible Anopheles culicifacies s.l.. This study presents the observations on (a) regeneration time, the period required to regenerate insecticide in the LLIN after three consecutive WHO standard washes in a single day to deplete the insecticide on the net surface, and (b) wash resistance of the LLIN to retain bio-efficacy up to 20 repeated washes at intervals corresponding to the regeneration time in days. In the present evaluation, the regeneration time of HILNet® was determined as 2days. Wash resistance studies of HILNet® showed a knockdown rate of 100% up to 15 washes and 97% at the 20th wash and complied with the criteria of WHO knockdown rate of ≥ 95%. The mean active ingredient content from 0 to 20 washes was in the range of 5.8 to 6.04g/kg and met the WHO criteria of the product claim (± 25% g/kg). The insecticide un-impregnated control net has shown no detectable levels of alphacypermethrin. In this evaluation, HILNet® fulfilled the WHO laboratory (phase I) efficacy criteria based on the rates of knockdown up to 20 standard WHO washes.

The past, present, and future of the semen analysis

This month's Views and Reviews provides an added perspective to the World Health Organization laboratory manual for the examination and processing of human semen, which was recently published in the 6th edition. The first artice provides a historical context of the prior editions of the World Health Organization manuals and modifications adopted over the years. The next piece then provides additional perspectives on the methodologies used for the performance of semen analysis. The third article then examines some of the new semen analytic technologies and enhancements that have become more common over the years. Finally, the last article proposed where male reproductive testing will head in the coming years with emerging research and technologies.

Implementation of the COVID-19 laboratory testing certification program (CoLTeP), Zimbabwe, 2021.

The Africa Union (AU) Trusted Travel Initiative was introduced in 2021 to support Africa Union member states enhance their current health screening systems. Trusted Travel offers an online digital platform for the verification and authentication of COVID-19 results based on a collaborative effort across a network of participating COVID-19 testing laboratories. In this paper, we describe the certification process of laboratories to qualify for listing on the AU Trusted Travel platform as approved and recognized COVID-19 testing facilities. A checklist prepared from the ISO15189: 2012, ISO15190: 2020 and World Health Organization Laboratory Safety Manual, 4th edition was used to audit laboratories. Approved auditors completed the audit checklist through reviewing laboratory documents and records, observing laboratory operations whilst asking open-ended questions to clarify documentation seen and observations made. A laboratory was recommended for certification after scoring at least 90%. Between May and September 2021, a total of 26 (19%) of the 134 medical laboratories authorized for SARS-CoV-2 testing had been audited for CoLTeP certification in Zimbabwe. The majority 16 (62%) attained 5 stars rating with 10 (38%) attaining 0-4 stars. Performance was highest in the area of test result and data management (mean score 93%, SD 9.1). The least performance of the laboratories was on the laboratory biosafety and biosecurity (mean score 73%, SD 17.0) and Quality Control and Assurance (mean score 71%, SD 15.0). There is need for laboratories to commit their resources to quality assurance programs and training of laboratory personnel in biosafety and biosecurity as part of continuous quality improvement.