The Performance of Pooled 3 Anatomic Site Testing for Chlamydia trachomatis and Neisseria gonorrhoeae Among Men Who Have Sex With Men and Transgender Women

Bristow, Claire; Mehta, Sanjay R.; Hoenigl, Martin

doi:10.1097/olq.0000000000001411

Cited by 7 publications

(7 citation statements)

References 31 publications

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“…24,26,27 Regarding the evaluation of two syphilis RDTs, our study demonstrated 100.0% agreement between the two readers, suggesting that the tests were easy to interpret which is consistent with a study in Burkina Faso which has also shown that syphilis RDTs have solid operational characteristics and easy-tointerpret results. 11 The overall prevalence syphilis infection of 10.5% is relatively low compared to a 2018 study in Thailand (12.0%) 25 but remains high compared to pooled prevalence of syphilis among MSM globally (7.5%) 3 and in Asia (9.9%). 28 The high prevalence of syphilis infection among our study participants could be explained by this study being conducted at a tertiary center offering STI treatment.…”

Section: Discussionmentioning

confidence: 86%

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Good performance of syphilis rapid diagnostic test kits among young key populations in Thailand

et al. 2023

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Background The prevalence of syphilis is increasing among adolescents and young adults (AYAs) globally. Use of syphilis rapid diagnostic treponemal tests (RDTs) may improve test coverage and same-day treatment. This study aims to determine sensitivity and specificity of two syphilis RDTs. Methods A cross-sectional study was conducted in men who have sex with men and transgender women aged 15–24 years attending a sexual health clinic in Bangkok. Syphilis RDTs used were Determine Syphilis TP and Bioline Syphilis 3.0, using whole blood from finger pricks and venipuncture. Treponemal pallidum electrochemiluminescence assay was used as standard reference. Results From February to July 2022, 200 AYAs with a mean age 21.1 (SD2.1) years were enrolled, including 50 (25.0%) living with HIV. Prevalence of syphilis was 10.5% (95%CI 6.6–15.6), which was higher among AYAs living with HIV (22.0%) compared with AYAs unaffected by HIV (6.7%). Sensitivities of Determine Syphilis TP and Bioline Syphilis 3.0 were 85.7% (95%CI 63.7–97.0) and 66.7% (95%CI 43.0–85.4), respectively. Specificity of both RDTs was 100% (95%CI 98.0–100.0). Performance of RDTs was similar for both specimens. Conclusions Syphilis RDTs have high sensitivity and specificity in diagnosing syphilis. It should be considered for use in sexual health clinics with high syphilis prevalence to initiate treatment promptly.

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Section: Discussionmentioning

confidence: 86%

“…The prevalence of syphilis infection was assumed to be 12.0% based on a previous study. 25 Accepting a marginal error of 15%, 187 participants were required. To account for an estimated 10% of insufficient specimens, we included 200 participants in this study.…”

Section: Discussionmentioning

confidence: 99%

Good performance of syphilis rapid diagnostic test kits among young key populations in Thailand

et al. 2023

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“…Our search yielded a total of 71 publications, 31 of which were in duplicate from another database. Fourteen met our inclusion criteria, [12][13][14][15][16][17][18][19][20][21][22][23][24][25] and 26 were excluded because they were not studies evaluating pooled testing, were overlapping data sets, or were a commentary, meta-analysis or review article (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Pooled 3-Anatomic-Site Testing for Chlamydia trachomatis and Neisseria gonorrhoeae: A Systematic Review and Meta-Analysis

Almeria¹,

Pham²,

Paris³

et al. 2021

Sexual Trans Dis

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Background: Pooled testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) may be a cost-saving solution to increase screening by simplifying testing procedures and reducing resource burdens. We conducted a systematic review and meta-analysis to examine the performance of pooled 3-anatomic-site testing (pharyngeal, rectal, and urogenital sites) for CT and NG in comparison with single-anatomic-site testing. Methods:We conducted a systematic literature search in PubMed, Embase, and Web of Science to identify original evaluation studies of the performance of pooled testing for CT and NG infections and identified 14 studies for inclusion. Each study was systematically evaluated for bias. We conducted bivariate fixed-effects and random-effects meta-analyses using a full Bayesian method of the positive percent agreement and negative percent agreement. Results:The combined positive percent agreement for CT was 93.11% (95% confidence interval [CI], 91.51%-94.55%), and the negative percent agreement was 99.44% (95% CI, 99.18%-99.65%). For NG, the combined positive percent agreement was 93.80% (95% CI, 90.26%-96.61%), and the negative percent agreement was 99.73% (95% CI, 99.30%-99.97%). Conclusions:We found that pooled 3-anatomic-site tests performed similarly to single-anatomic-site tests for the detection of CT and NG. The pooled 3-anatomic-site tests have the added potential benefit of reduced cost and resource requirement, which could lead to improved testing access and screening uptake.

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“…While testing multiple anatomical sites separately is ideal, increase of cost and/or workload related to this testing strategy would be one of the major concerns. To respond to this concern, several studies have investigated the diagnostic accuracy of pooled specimens from the three anatomical sites (urethra, pharynx and rectum) to detect CT and NG 8–18. Among these studies, the ex-ante pooling approach8–10 12 14 17 or the ex-post11 13 15 16 18 were used.…”

Section: Introductionmentioning

confidence: 99%

“…To respond to this concern, several studies have investigated the diagnostic accuracy of pooled specimens from the three anatomical sites (urethra, pharynx and rectum) to detect CT and NG 8–18. Among these studies, the ex-ante pooling approach8–10 12 14 17 or the ex-post11 13 15 16 18 were used. Ex-ante pooling is placing the original single-site specimens in a tube with transport media, while ex-post pooling is making a pool of the transport media from both anorectal and oropharyngeal specimens and the urine.…”

Section: Introductionmentioning

confidence: 99%

Using pooled urogenital, anorectal and oropharyngeal specimens to detectChlamydia trachomatisandNeisseria gonorrhoeaeamong men who have sex with men in China: a multisite diagnostic accuracy study

et al. 2023

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ObjectivesScreening forChlamydia trachomatis(CT) andNeisseria gonorrhoeae(NG) at both urogenital and extragenital sites has been recommended in many countries. Testing of the infections using pooled specimens from urogenital and extragenital sites offer the opportunity to shorten the testing time and reduce the testing cost. Ex-ante pooling is placing the original single-site specimens in a tube with transport media, while ex-post pooling is making a pool of the transport media from both anorectal and oropharyngeal specimens and the urine. This study aimed to conduct a multisite performance evaluation of two pool-specimen approaches (ex-ante and ex-post) in detection of CT and NG using the Cobas 4800 platform among men who have sex with men (MSM) in China.DesignDiagnostic accuracy study.Setting, participants and outcome measuresParticipants were recruited from MSM communities at six cities in China. Two oropharyngeal and anorectal swabs collected by clinical staff and 20 mL first-void urine collected by the participant himself were used for evaluating sensitivity and specificity.ResultsA total of 1311 specimens were collected from 437 participants in six cities. The sensitivities of ex-ante pooling approach as compared with single-specimen approach (reference standard) were 98.7% (95% CI, 92.7% to 100.0%) for detection of CT and 89.7% (95% CI, 75.8% to 97.1%) for NG, and the specificities were 99.5% (95% CI, 98.0% to 99.9%) and 98.7% (95% CI, 97.1% to 99.6%), respectively. The sensitivities of ex-post pooling approach were 98.7% (95% CI, 92.7% to 100.0%) for CT and 100.0% (95% CI, 91.0% to 100.0%) for NG, and the specificities were 100.0% (95% CI, 99.0% to 100.0%) and 100.0% (95% CI, 99.1% to 100.0%), respectively.ConclusionsThe ex-ante and ex-post pooling approaches show good sensitivity and specificity in detecting urogenital and extragenital CT and/or NG, indicating that these approaches can be used in epidemiological surveillance and clinical management of CT and NG infections, particularly among MSM population.

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The Performance of Pooled 3 Anatomic Site Testing for Chlamydia trachomatis and Neisseria gonorrhoeae Among Men Who Have Sex With Men and Transgender Women

Cited by 7 publications

References 31 publications

Good performance of syphilis rapid diagnostic test kits among young key populations in Thailand

Good performance of syphilis rapid diagnostic test kits among young key populations in Thailand

Pooled 3-Anatomic-Site Testing for Chlamydia trachomatis and Neisseria gonorrhoeae: A Systematic Review and Meta-Analysis

Using pooled urogenital, anorectal and oropharyngeal specimens to detectChlamydia trachomatisandNeisseria gonorrhoeaeamong men who have sex with men in China: a multisite diagnostic accuracy study

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