"It was difficult to offer same day results": evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the GeneXpert platform in Zimbabwe.
"It was difficult to offer same day results": evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the GeneXpert platform in Zimbabwe.
复制标题
“很难在同一天提供结果”：在津巴布韦使用GeneXpert平台对基于社区的青年性传播感染护理点检测进行评价。
DOI：
10.1186/s12913-022-07557-7
复制
发表时间：
2022-02-10
影响因子：
2.8
通讯作者：
Ferrand RA
中科院分区：
文献类型：
--
作者：
Martin K;Dziva Chikwari C;Mackworth-Young CRS;Chisenga M;Bandason T;Dauya E;Olaru ID;Francis SC;Mavodza C;Nzombe P;Nyamwanza R;Hove F;Tshuma M;Machiha A;Kranzer K;Ferrand RA
性传播感染（STIs）的即时检测可以改善中低收入国家对STIs的诊断和治疗。我们探讨了促进因素和障碍，以点的护理检测沙眼衣原体（CT）和淋病奈瑟菌（NG）的青年在以社区为基础的设置在津巴布韦。这项研究是嵌套在一个集群随机试验，以社区为基础的综合艾滋病毒和性健康和生殖健康服务的16至24岁的青年交付。使用Xpert® CT/NG检测试剂盒对尿液样本进行现场CT/NG检测，在四个干预集群中进行试点，由服务提供商进行检测。现场检测定义为在样本采集当天和研究中心进行样本处理。结果包括现场处理的测试比例，样本收集和结果收集之间的时间，以及接受治疗的客户比例。对9家服务提供商和3名提供研究协调或实验室支持的工作人员进行了深入访谈，以探讨提供现场CT/NG检测的促进因素和障碍。在847次Xpert检测中，296次（35.0%）在现场进行。其中，61例（20.6%）CT/NG阳性; 1例（1.6%）在同一天接受了病原学治疗; 33例（54.1%）晚些时候接受治疗; 5例（8.2%）作为综合征管理的一部分接受治疗。无论样本是在现场还是非现场处理，接受治疗的客户比例均无差异（64%（39/61）vs 60%（66/110）; p = 0.61）。对于现场和非现场处理的样本，样本采集和阳性结果采集之间的中位数（IQR）天数分别为14（7-35）和14（7-52.5）。访谈揭示了与i）诊断器械ii）环境，iii）提供者和iv）客户相关的现场检测相关的四个主题。查明的一些具体障碍包括检测能力不足、空间不足以及客户不愿等待结果。除了研究优化在资源有限的环境中实施性传播感染的即时检测外，还需要开发新的平台来减少分析时间，以扩大性传播感染检测并减少检测和治疗之间的损耗。在临床trials.gov（NCT 03719521）中注册。在线版本包含补充材料，可通过10.1186/s12913-022-07557-7获得。
Point-of-care testing for sexually transmitted infections (STIs) may improve diagnosis and treatment of STIs in low- and middle-income counties. We explored the facilitators and barriers to point-of-care testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG) for youth in community-based settings in Zimbabwe. This study was nested within a cluster randomised trial of community-based delivery of integrated HIV and sexual and reproductive health services for youth aged 16 to 24 years. On-site CT/NG testing on urine samples using the Xpert® CT/NG test was piloted in four intervention clusters, with testing performed by service providers. On-site testing was defined as sample processing on the same day and site as sample collection. Outcomes included proportion of tests processed on-site, time between sample collection and collection of results, and proportion of clients receiving treatment. In-depth interviews were conducted with nine service providers and three staff members providing study co-ordination or laboratory support to explore facilitators and barriers to providing on-site CT/NG testing. Of 847 Xpert tests, 296 (35.0%) were performed on-site. Of these, 61 (20.6%) were positive for CT/NG; one (1.6%) received same day aetiological treatment; 33 (54.1%) presented later for treatment; and 5 (8.2%) were treated as a part of syndromic management. There was no difference in the proportion of clients who were treated whether their sample was processed on or off-site (64% (39/61) vs 60% (66/110); p = 0.61). The median (IQR) number of days between sample collection and collection of positive results was 14 (7–35) and 14 (7–52.5) for samples processed on and off-site, respectively, The interviews revealed four themes related to the provision of on-site testing associated with the i) diagnostic device ii) environment, iii) provider, and iv) clients. Some of the specific barriers identified included insufficient testing capacity, inadequate space, as well as reluctance of clients to wait for their results. In addition to research to optimise the implementation of point-of-care tests for STIs in resource-limited settings, the development of new platforms to reduce analytic time will be necessary to scale up STI testing and reduce the attrition between testing and treatment. Registered in clinical trials.gov (NCT03719521). The online version contains supplementary material available at 10.1186/s12913-022-07557-7.
登录
查看更多内容
DOI：
10.1016/s2352-4642(20)30335-7
发表时间：
2021-03
期刊：
The Lancet. Child & adolescent health
影响因子：
--
作者：
Martin K;Olaru ID;Buwu N;Bandason T;Marks M;Dauya E;Muzangwa J;Mabey D;Dziva Chikwari C;Francis SC;Tembo M;Mavodza C;Simms V;Mackworth-Young CRS;Machiha A;Kranzer K;Ferrand RA
通讯作者：
Ferrand RA
影响因子：
3.7
作者：
Der, Joyce B.;Grint, Daniel;Grant, Alison D.
通讯作者：
Grant, Alison D.
影响因子：
--
作者：
Cazabon, Danielle;Pande, Tripti;Pai, Madhukar
通讯作者：
Pai, Madhukar
影响因子：
3.7
作者：
Garrett, Nigel J.;Osman, Farzana;Mindel, Adrian
通讯作者：
Mindel, Adrian
影响因子：
14.2
作者：
Badman, S. G.;Willie, B.;Kelly-Hanku, A.
通讯作者：
Kelly-Hanku, A.