Could point-of-care testing be effective for reducing the prevalence of trichomoniasis in remote Aboriginal communities?

Sexual Health ◽  
2014 ◽  
Vol 11 (4) ◽  
pp. 370
Author(s):  
Ben B. Hui ◽  
James Ward ◽  
Louise Causer ◽  
Rebecca J. Guy ◽  
Matthew G. Law ◽  
...  
Keyword(s):  
Mathematical Modelling ◽  
Older Women ◽  
Point Of Care ◽  
Indigenous Communities ◽  
Treatment Programs ◽  
Point Of Care Testing ◽  
Aboriginal Communities ◽  
Sexually Transmissible Infections ◽  
High Prevalence ◽  
The Impact

High prevalence of trichomoniasis is reported for many remote Indigenous communities despite intensive screening and treatment programs. Mathematical modelling has previously been used to show that point-of-care (POC) testing for gonorrhoea and chlamydia has the potential to increase the impact of screening in reducing the prevalence of these sexually transmissible infections. The study was extended to estimate the impact of a rapid POC test for trichomoniasis. The results suggest that POC testing in place of conventional testing will also provide additional reductions in trichomoniasis prevalence. However, more emphasis should be placed on testing for trichomoniasis in older women due to the high prevalence observed in this group.

The potential impact of new generation molecular point-of-care tests on gonorrhoea and chlamydia in a setting of high endemic prevalence

Sexual Health ◽  
2013 ◽  
Vol 10 (4) ◽  
pp. 348 ◽  
Author(s):  
Ben B. Hui ◽  
David P. Wilson ◽  
James S. Ward ◽  
Rebecca J. Guy ◽  
John M. Kaldor ◽  
...  
Keyword(s):  
Point Of Care ◽  
Treatment Strategies ◽  
High Sensitivity ◽  
Indigenous Communities ◽  
Great Promise ◽  
Screening Methods ◽  
Sexually Transmissible Infections ◽  
Screening Coverage ◽  
New Generation ◽  
The Impact

Background Despite the availability of testing and treatment, bacterial sexually transmissible infections (STIs) continue to occur at endemic levels in many remote Indigenous communities in Australia. New generation molecular point-of-care (POC) tests have high sensitivity, comparable with conventional diagnostic tests, and have the potential to increase the impact of STI screening. Methods: We developed mathematical models of gonorrhoea (Neisseria gonorrhoeae) and chlamydia (Chlamydia trachomatis) transmission in remote Indigenous communities in Australia to evaluate screening and treatment strategies that utilise POC tests. Results: The introduction of POC testing with 95% sensitivity could reduce the prevalence of gonorrhoea and chlamydia from 7.1% and 11.9% to 5.7% and 8.9%, respectively, under baseline screening coverage of 44% per year. If screening coverage is increased to 60% per year, prevalence is predicted to be reduced to 3.6% and 6.7%, respectively, under conventional testing, and further reduced to 1.8% and 3.1% with the introduction of POC testing. Increasing screening coverage to 80% per year will result in a reduction in the prevalence of gonorrhoea and chlamydia to 0.6% and 1.5%, respectively, and the virtual elimination of both STIs if POC testing is introduced. Conclusions: Modelling suggests that molecular POC tests of high sensitivity have great promise as a public health strategy for controlling chlamydia and gonorrhoea. However, evaluation of the cost-effectiveness of POC testing needs to be made before widespread implementation of this technology can be considered.

Point of care testing: The impact of nanotechnology

2017 ◽  
Vol 87 ◽  
pp. 373-387 ◽  
Author(s):  
Leila Syedmoradi ◽  
Maryam Daneshpour ◽  
Mehrdad Alvandipour ◽  
Frank A. Gomez ◽  
Hassan Hajghassem ◽  
...  
Keyword(s):  
Point Of Care ◽  
Point Of Care Testing ◽  
The Impact

scholarly journals 2796. The Impact of Syndromic Molecular Point-of-Care Testing for Respiratory Viruses on Antibiotic Use in Adults Presenting to Hospital with Exacerbation of Airways Disease: Further Analysis From a Randomized Controlled Trial

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S988-S988
Author(s):  
Tristan William Clark ◽  
Samuel Mills ◽  
Nathan Brendish
Keyword(s):  
Point Of Care ◽  
Survival Curve ◽  
Controlled Trial ◽  
Antibiotic Use ◽  
Respiratory Viruses ◽  
Influenza Viruses ◽  
Rank Test ◽  
Point Of Care Testing ◽  
Early Discontinuation ◽  
The Impact

Abstract Background The ResPOC study demonstrated that syndromic molecular point-of-care testing (POCT) for respiratory viruses was associated with earlier discontinuation of unnecessary antibiotics. Subgroup analysis suggests this occurs predominantly in patients with exacerbation of airways disease. Molecular POCT use is becoming widespread but there is a lack of evidence to inform the choice between multiplex syndromic panels vs. uniplex tests for influenza. Methods We evaluated patients with exacerbation of asthma or COPD who were treated with antibiotics. The duration of antibiotics and proportion with early discontinuation were compared between patients testing positive for viruses by POCT (FilmArray Respiratory Panel) those testing negative by POCT and controls. Patients testing positive for viruses by POCT were compared according to virus types detected. Survival curves were generated for duration of antibiotics and compared using the log-rank test. Results There were 118 patient with exacerbation of airways disease in the POCT group who received antibiotics and 111 in the controls. In the POCT group 49/118 (42%) patients tested positive for viruses. Of those testing positive for viruses by POCT 17/49 (35%) had early discontinuation of antibiotics vs. 9/81 (13%) in those testing negative and 7/111 (6%) in controls, P < 0.0001. Survival curve analysis showed a reduced time to antibiotic discontinuation in those testing positive for viruses, P = 0.034. Of those positive for viruses by POCT 20% were positive for influenza, 43% for rhinovirus and 37% for other viruses combined. The proportion with early discontinuation of antibiotics was not different between the virus types, P = 0.53. Conclusion Syndromic molecular POCT for viruses in adults with exacerbation of airways disease leads to early discontinuation in those positive for viruses. As most viruses detected were non-influenza viruses and there was no difference in antibiotic use between virus types, syndromic molecular POCT for respiratory viruses should be favored over uniplex POCT for influenza. Disclosures All authors: No reported disclosures.

scholarly journals Editorial Volume 19 Issue 1 – “Eternal Winter”: Acute Medicine the key to providing longer periods of summer

2020 ◽  
Vol 19 (1) ◽  
pp. 2-3
Author(s):  
Tim Cooksley ◽  
Keyword(s):  
Respiratory Rate ◽  
Ambulatory Care ◽  
Acute Care ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Point Of Care Testing ◽  
Acute Medicine ◽  
Care Services ◽  
Acute Care Services ◽  
The Impact

As another winter season passes, many colleagues will continue to be working under immense pressures striving to provide high quality care for increasingly larger numbers of patients. The work of Acute Medicine teams to keep the “front door” safe are fundamental to the delivery and sustainability of acute care services. The challenges of innovating and enacting positive changes at times of such high service demand are not insignificant; but the specialty is blessed with rapidly expanding driven and dedicated international, national and local leaders. The first winter SAMBA has recently been performed. SAMBA is an increasingly rich data source that will serve both nationally and locally to help improve performance and ultimately patient outcomes.1 Higher quality Acute Medicine is being produced. Acute Physicians are leading in many acute sub-specialties. Pleasingly, there has a been a significant rise in the number of trainees applying to train in Acute Medicine in the UK reflecting the traction the specialty is achieving. Ambulatory care remains a fundamental tenet to the sustainability of acute care services. Point of care testing is a key element in driving efficient performance in this setting and in this issue Verbakel et al. perform an important analysis on the reliability of point of care testing to support community based ambulatory care.2 This work should field the way for further research defining the impact of point of care testing and how it should be implemented in ambulatory clinical practice. The performance of respiratory rate observation remains poorly performed in acute care settings despite its well validated predictive value. Nakitende et al. describe an app that allows respiratory rate to calculated more quickly and accurately by using a touch screen method.3 Technological innovations to improve the recording and accuracy of physiological parameters in acute care, which can also be used in resource poor settings, will be a focus of large quantities of research in the upcoming years. Blessing et al. describe an important modelling study on the impact of integrated radiology units.4 Co-ordination between Acute Medicine and Radiology departments is essential in a high functioning AMU, especially as increasingly Acute Physicians are trained in point of care ultrasound. Lees-Deutsch et al. provide a fascinating insight into the patient’s perspective of discharge lounges.5 Often used to help maintain flow through the hospital, they elucidate that patients and caregivers transferred from AMU do not find this aspect of their journey a positive one. In times of significant organisational pressures, it is important that clinicians continue to examine the impact of flow measures on the quality of patient care and experience.

Sign in / Sign up

Export Citation Format

Share Document