Management of cases testing positive for gonococcal infection in a community-based chlamydia screening programme

Downing, Jennifer; Cook, Penny A.; Madden, Hannah; Phillips-Howard, Penelope A.; Higgins, Stephen P.; Bellis, Mark A

doi:10.1136/sti.2010.043240

Cited by 5 publications

(7 citation statements)

References 10 publications

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“…In every study, an initial positive NAAT underwent supplementary testing, although there were differences in the method used. In most laboratories, a positive sample was retested using another NAAT detecting a different target 3 4 6–10 12. Some repeated the test on residual samples using the original assay11 13 14 which, in fact, demonstrates reproducibility rather than confirmation.…”

Section: Resultsmentioning

confidence: 99%

Nucleic acid amplification tests for the diagnosis ofNeisseria gonorrhoeaein low-prevalence settings: a review of the evidence: Table 1

Fifer

Ison

2014

Sex Transm Infect

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Section: Resultsmentioning

confidence: 99%

Nucleic acid amplification tests for the diagnosis ofNeisseria gonorrhoeaein low-prevalence settings: a review of the evidence: Table 1

Fifer

Ison

2014

Sex Transm Infect

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“…Further data collection is needed to gauge how successful this process is, although a recent paper discusses the management of community-based GC infection with suggestions for improvement. 8 The number of areas changing to dual CT/GC testing is increasing, the increase being driven by laboratories moving to dual testing to comply with what is felt to be 'best practice' and the fact that the cost for the additional NAAT is usually minimal. There has been recent discussion about whether to test asymptomatic men in GU medicine departments for GC.…”

Section: Discussionmentioning

confidence: 99%

“…However, screening levels have continued to increase and a recent study found that clients thought it beneficial to test for both infections. 5 If GC testing is carried out in the laboratory the result must be reported; those participating must be made aware of this and consent obtained for both CT and GC tests.…”

Section: Discussionmentioning

confidence: 99%

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Positive nucleic acid amplification tests for Neisseria gonorrhoeae in young people tested as part of the National Chlamydia Screening Programme

Skidmore

Copley²,

Cordwell³

et al. 2011

Int J STD AIDS

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Little information is available on the prevalence of Neisseria gonorrhoeae (GC) infections outside genitourinary (GU) medicine clinics. A number of National Chlamydia Screening Programme areas now carry out simultaneous testing for Chlamydia trachomatis (CT) and GC in a single sample using nucleic acid amplification tests (NAATs). The aim of this study was to gather together data on dual testing from community settings. Information was collected from five programme areas. A total of 219,412 results were recorded with 18,370 CT positives, 1226 GC positives and among these 554 were with dual CT/GC infection. These figures highlight the fact that substantial numbers of positive GC NAAT results are found outside GU settings. An assessment of both the prevalence of GC and the proportion of extra cases that can be detected in all settings is needed, together with the implementation of robust plans to confirm, treat and manage these patients.

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“…comprehensive RSE is an essential component in the process of reducing unintended pregnancy rates, as well as being a vital aspect of improving holistic sexual health and well-being. [27][28][29][30][31][32][33] The UK governments emphasise the policy importance of the implementation of RSE in schools in decreasing conception rates for those aged < 18 years and the promotion of positive sexual health among teenagers. [34][35][36] Current status of relationships and sexuality education…”

Section: Implications For Researchmentioning

confidence: 99%

School-based relationship and sexuality education intervention engaging adolescent boys for the reductions of teenage pregnancy: the JACK cluster RCT

Lohan,

Gillespie,

Aventin

et al. 2023

Public Health Res

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Background The need to engage boys in gender-transformative relationships and sexuality education (RSE) to reduce adolescent pregnancy is endorsed by the World Health Organization and the United Nations Educational, Scientific and Cultural Organization. Objectives To evaluate the effects of If I Were Jack on the avoidance of unprotected sex and other sexual health outcomes. Design A cluster randomised trial, incorporating health economics and process evaluations. Setting Sixty-six schools across the four nations of the UK. Participants Students aged 13–14 years. Intervention A school-based, teacher-delivered, gender-transformative RSE intervention (If I Were Jack) versus standard RSE. Main outcome measures Self-reported avoidance of unprotected sex (sexual abstinence or reliable contraceptive use at last sex) after 12–14 months. Secondary outcomes included knowledge, attitudes, skills, intentions and sexual behaviours. Results The analysis population comprised 6556 students: 86.6% of students in the intervention group avoided unprotected sex, compared with 86.4% in the control group {adjusted odds ratio 0.85 [95% confidence interval (CI) 0.58 to 1.26], p = 0.42}. An exploratory post hoc analysis showed no difference for sexual abstinence [78.30% intervention group vs. 78.25% control group; adjusted odds ratio 0.85 (95% CI 0.58 to 1.24), p = 0.39], but more intervention group students than control group students used reliable contraception at last sex [39.62% vs. 26.36%; adjusted odds ratio 0.52 (95% CI 0.29 to 0.920), p = 0.025]. Students in schools allocated to receive the intervention had significantly higher scores on knowledge [adjusted mean difference 0.18 (95% CI 0.024 to 0.34), p = 0.02], gender-equitable attitudes and intentions to avoid unintended pregnancy [adjusted mean difference 0.61 (95% CI 0.16 to 1.07), p = 0.01] than students in schools allocated to receive the control. There were positive but non-significant differences in sexual self-efficacy and communication skills. The total mean incremental cost of the intervention compared with standard RSE was £2.83 (95% CI –£2.64 to £8.29) per student. Over a 20-year time horizon, the intervention is likely to be cost-effective owing to its impact on unprotected sex because it would result in 379 (95% CI 231 to 477) fewer unintended pregnancies, 680 (95% CI 189 to 1467) fewer sexually transmitted infections and a gain of 10 (95% CI 5 to 16) quality-adjusted life-years per 100,000 students for a cost saving of £9.89 (95% CI –£15.60 to –£3.83). Limitations The trial is underpowered to detect some effects because four schools withdrew and the intraclass correlation coefficient (0.12) was larger than that in sample size calculation (0.01). Conclusions We present, to our knowledge, the first evidence from a randomised trial that a school-based, male engagement gender-transformative RSE intervention, although not effective in increasing avoidance of unprotected sex (defined as sexual abstinence or use of reliable contraception at last sex) among all students, did increase the use of reliable contraception at last sex among students who were, or became, sexually active by 12–14 months after the intervention. The trial demonstrated that engaging all adolescents early through RSE is important so that, as they become sexually active, rates of unprotected sex are reduced, and that doing so is likely to be cost-effective. Future work Future studies should consider the longer-term effects of gender-transformative RSE as students become sexually active. Gender-transformative RSE could be adapted to address broader sexual health and other settings. Trial registration This trial is registered as ISRCTN10751359. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (PHR 15/181/01) and will be published in full in Public Health Research; Vol. 11, No. 8. See the NIHR Journals Library website for further project information.

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Management of cases testing positive for gonococcal infection in a community-based chlamydia screening programme

Cited by 5 publications

References 10 publications

Nucleic acid amplification tests for the diagnosis ofNeisseria gonorrhoeaein low-prevalence settings: a review of the evidence: Table 1

Nucleic acid amplification tests for the diagnosis ofNeisseria gonorrhoeaein low-prevalence settings: a review of the evidence: Table 1

Positive nucleic acid amplification tests for Neisseria gonorrhoeae in young people tested as part of the National Chlamydia Screening Programme

School-based relationship and sexuality education intervention engaging adolescent boys for the reductions of teenage pregnancy: the JACK cluster RCT

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