Point-of-care diagnostics for sexually transmitted infections among migrants in Greece

IF 1.3 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2024-03-01 DOI:10.5588/pha.23.0022

C. Tsorou, A. Williams, W. van den Boogaard, N. Staderini, E. Repetto, A. Terzidis, E. Pikoulis

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Abstract

SETTINGSexually transmitted infections (STIs) can impact individuals of any demographic. The most common pathogens causing STIs are Chlamydia trachomatis, Neisseria gonorrhea and Trichomonas vaginalis; these can be treated with specific antibiotics.OBJECTIVETo compare the GeneXpert CT/NG test-and-treat algorithm to the syndromic approach algorithm and their impact on antibiotic prescription for gonorrhoea and chlamydia STIs.DESIGNA retrospective observational study on women aged ≥18 years who accessed the Médecins Sans Frontières Day Care Centre in Athens with complaints related to urogenital infections between January 2021 and March 2022. Women with abnormal vaginal discharge, excluding clinically diagnosed candidiasis, were eligible for Xpert CT/NG testing.RESULTSOf the 450 women who accessed care, 84 were eligible for Xpert CT/NG testing, and only one was positive for chlamydia, therefore resulting in saving 81 doses of ceftriaxone and azithromycin, and 19 doses of metronidazole. The cost of Xpert CT/NG testing, including treatment was €4,606.37, while full antibiotic treatment would have costed €536.76.CONCLUSIONThe overall cost of the Xpert CT/NG test-and-treat algorithm was higher than the syndromic approach. However, quality of care should be weighed against the potential benefits of testing and syndromic treatment to determine the best option for each patient; we therefore advocate for decreasing the costs.

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希腊移民中性传播感染的床旁诊断法

背景性传播感染（STI）可影响任何人群。目的比较 GeneXpert CT/NG 检测和治疗算法与综合征方法算法及其对淋病和衣原体 STI 抗生素处方的影响。DESIGNA 回顾性观察研究：2021 年 1 月至 2022 年 3 月期间，年龄≥18 岁的女性在雅典无国界医生日间护理中心就诊并提出与泌尿生殖系统感染相关的主诉。结果在 450 名就诊妇女中，84 人符合 Xpert CT/NG 检测条件，只有一人衣原体检测呈阳性，因此节省了 81 剂头孢曲松和阿奇霉素以及 19 剂甲硝唑。Xpert CT/NG 检测（包括治疗）的费用为 4,606.37 欧元，而全部抗生素治疗的费用为 536.76 欧元。然而，在权衡医疗质量与检测和综合征治疗的潜在益处时，应为每位患者选择最佳方案；因此，我们主张降低成本。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.