A Practical Guide to Establishing a Molecular-Based Point-of-Care Testing Network for Chlamydia

Abstract

This chapter provides a ‘how to guide’ to set up and manage a molecular-based point-of-care (POC) testing network to detect Chlamydia trachomatis (Chlamydia) in populations experiencing high burden of infection and sequelae as well as barriers to accessing routine laboratory services. The chapter outlines the experience of the Australian-based Test, Treat and Go (TTANGO) program which, to the authors’ knowledge, represents the largest decentralised POC testing network for chlamydia (as well as gonorrhoea and trichomoniasis) in the primary care sector globally. The chapter provides an overview of the program’s evolution from a randomised controlled trial through implementation, translation, and scale-up phases to a now national routine program with associated testing rebates. The chapter will examine the governance, training and quality management, and connectivity processes that underpin the TTANGO network and describe the clinical, cultural, operational and economic effectiveness of the network. Collectively, these elements provide a template for translation to low- and middle-income countries (LMIC) where Chlamydia trachomatis remains a significant contemporary health problem.