Performance and operational characteristics of point-of-care tests for the diagnosis of urogenital gonococcal infections.
Sex Transm Infect
; 93(S4): S16-S21, 2017 12.
Article
em En
| MEDLINE
| ID: mdl-29223959
ABSTRACT
BACKGROUND:
In 2012, there was an estimated 78 million new cases of gonorrhoea globally. Untreated infection may lead to reproductive and neonatal morbidity and facilitate HIV transmission. Diagnosis and treatment are a priority for control and prevention, yet use of point-of-care tests (POCTs) for Neisseria gonorrhoeae (NG) is limited.OBJECTIVES:
To review the performance and operational characteristics of NG POCTs for diagnosis of urogenital gonorrhoea.METHODS:
We compiled and synthesised findings from two separate systematic reviews which included evaluations published until August 2015.RESULTS:
Six tests were included five were immunochromatographic tests (ICTs) or optical immunoassay (OIAs) based on antigen detection; with 5-7 steps and results in 25-40 min, and one (GeneXpert CT/NG) was a 'near-patient test' based on nucleic acid amplification technique (NAAT); with three steps, electricity required, and results in 90 min. When compared with laboratory-based NAATs as the reference tests, sensitivities of ICT and OIA-based POCTs ranged from 12.5% to 70% when cervical/vaginal swabs were tested. Specificities ranged from 89% to 99.8%. The near-patient NAAT had sensitivities of >95% and specificities of >99.8% consistently across all specimen types (urine, cervical and vaginal swabs).CONCLUSIONS:
Based on a limited number of evaluations, antigen detection POCTs for NG lacked sufficient sensitivity to be used for screening. A near-patient NAAT has acceptable performance, only involved a few steps, but needs electricity, a temperature-controlled environment and has a 90 min run time. To achieve wider scale up of NG POCTs, we need strong evidence of cost-effectiveness, which should inform guidelines and ultimately increase test development, demand and reduce costs.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
DNA Bacteriano
/
Gonorreia
/
Cromatografia de Afinidade
/
Sistemas Automatizados de Assistência Junto ao Leito
/
Técnicas de Amplificação de Ácido Nucleico
/
Neisseria gonorrhoeae
Tipo de estudo:
Diagnostic_studies
/
Guideline
Limite:
Humans
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article