Testing for gonorrhoea should routinely include the pharynx.
Testing for gonorrhoea should routinely include the pharynx.
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淋病检查应常规包括咽部检查。
DOI：
10.1016/s1473-3099(18)30341-4
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
White,PeterJ
中科院分区：
文献类型：
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作者：
Whittles,LilithK;Didelot,Xavier;Grad,YonatanH;White,PeterJ
世卫组织艾滋病毒护理的公共卫生方法要求通过社区服务扩大艾滋病毒检测，并在合并感染率高的环境中将艾滋病毒和病毒性肝炎服务纳入慢性病护理。1因此，艾滋病毒、乙型肝炎B病毒（HBV）和丙型肝炎病毒（HCV）检测的创新战略对于扩大其预防和治疗服务变得非常必要。2我们率先在喀麦隆全国使用移动的单位进行大规模艾滋病毒检测。3一种新的多重快速诊断试验（RDT）的开发，用于同时检测HIV、HCV特异性抗体和HBV表面抗原（HBsAg）4，促使我们评估其在移动的单位中用于大规模HIV、HBV和HCV筛查的有用性。2018年2月至4月，1206名志愿者（665名男性，541名女性;平均年龄31.9岁[范围18-91岁]）在知情同意后参加了喀麦隆城市和农村地区卫生区的免费筛查活动。将静脉血样本提交至移动的装置中，通过多重组合HIV/HCV/HBsAg（Triplex，Biosynex，斯特拉斯堡，法国，分析性能先前已验证4）对全血进行平行筛查，并通过CE IVD标记的ELISA（HIV、HBsAg和HCV）（HUMAN Diagnostics，威斯巴登，德国）对雅温得参考实验室中的血清进行平行筛查。对志愿者进行了筛选，并将结果反馈给他们。104例（9%）志愿者HBsAg阳性，25例（2%）HIV阳性，27例（2%）HCV阳性。所有多重RDT阳性和阴性样本均通过参考HIV、HBV和HCV ELISA进一步确认。1名志愿者HIV和HBsAg均呈阳性。所有经多重RDT检测呈血清阳性的志愿者都被转介到咨询和治疗中心。在向参考保健中心过渡的过程中，没有出现后续行动损失，表明立即提供了连续的护理。在移动的筛查活动中，12名接受筛查的成人中有1人受益于同时、快速的HIV、HBV和HCV检测。通过多重RDT进行大规模HIV、HBV和HCV检测的移动的单位方法可能会加强现有的预防和护理策略。多重RDT比单独使用的单特异性RDT具有更多的优势，通过最大限度地利用可用资源，并同时使用一滴血和仅一个测试设备提供多种病毒感染的快速结果。在撒哈拉以南非洲，同时使用低成本的多重HIV、HBV和HCV RDT与移动的单位相结合，可以明显改善筛查、预防策略和与护理的联系的级联，降低成本。
The WHO public health approach of HIV care requires expanded HIV testing through community-based services and integration of HIV and viral hepatitis services in chronic disease care in settings where rates of co-infection are high. 1 Innovative strategies for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) testing are thus becoming necessary to expand both their prevention and treatment services. 2 We pioneered the use of mobile units for mass HIV testing throughout Cameroon. 3 The development of a new multiplex rapid diagnostic test (RDT) for simultaneous detection of HIV, and HCV-specific antibodies, and HBV surface antigen (HBsAg) 4 prompted us to assess its usefulness in mobile units for mass HIV, HBV, and HCV screening. From February to April, 2018, 1206 volunteers (665 men, 541 women; mean age 31· 9 years [range 18–91]) were enrolled after informed consent during free screening campaigns in health districts in urban and rural areas in Cameroon. Venous blood samples were submitted for parallel screening in a mobile unit on whole blood by multiplex combination HIV/HCV/HBsAg (Triplex, Biosynex, Strasbourg, France, with analytical performances previously validated4), and on serum in a reference laboratory in Yaounde by CE IVD-labelled ELISAs for HIV, HBsAg, and HCV (HUMAN Diagnostics, Wiesbaden, Germany). Volunteers were screened and their results given back to them. 104 (9%) volunteers were positive for HBsAg, 25 (2%), for HIV and 27 (2%) for HCV. All samples positive and negative by multiplex RDT were further confirmed by reference HIV, HBV, and HCV ELISAs. One volunteer was positive for both HIV and HBsAg. All volunteers who were seropositive by multiplex RDT were referred to counselling and treatment centres. There was no loss to follow-up in the transition to reference health-care centres, demonstrating immediate continuum of care. One of 12 adults screened during mobile screening campaigns benefited from simultaneous, rapid, detection of HIV, HBV, and HCV. The mobile unit approach for mass HIV, HBV, and HCV testing by multiplex RDT may strengthen the prevention and care strategies in place. Multiplex RDT has more advantages than the monospecific RDTs used independently, by maximising available resources, and simultaneously providing rapid results for several viral infections with one single drop of blood and only one test device. In sub-Saharan Africa, the simultaneous use of low cost multiplex HIV, HBV, and HCV RDT in combination with mobile units may clearly improve the cascade of screening, prevention strategies, and linkage-to-care with reduced cost.