Performance evaluation and acceptability of point-of-care Trichomonas vaginalis testing in adult female emergency department patients.

We evaluated the accuracy and perception of a patient self-administered, tablet-facilitated rapid Trichomonas vaginalis (TV) point-of-care (POC) test in adult female emergency department (ED) patients.ED patients undergoing gynecologic examination were eligible. Each consented participant self-collected a vaginal swab, performed a tablet-facilitated TV rapid test using the OSOM® Trichomonas Rapid Test, and completed pre- and post-test self-surveys. After the self-test, the clinician collected one standard-of-care (SOC) vaginal swab for wet-mount testing and two for research. The research coordinator performed the TV rapid test using the clinician-collected swab, and reported the results to the clinician and patient. If the self- and coordinator-performed results were discordant, a TV nucleic acid amplification test (NAAT) was performed in a clinical laboratory. A survey was later administered to providers to assess their perceptions of the utility of the POC TV test.Of the 136 participants, 134 (98.5%) completed self-testing; two had invalid results. Comparing coordinator-performed TV rapid test adjudicated with NAAT, the sensitivity and specificity of self-administered test was 96.0% and 100%, respectively. The wet mount had a sensitivity of 52.0% and specificity of 100%. TV detection increased from 9.6% with wet mount to 18.4% with the TV rapid test. Most women (82.0%) stated self-testing was "not at all hard" (versus 66.2% before testing, p < 0.001). Clinicians indicated the TV rapid test affected their clinical management in 48.5% of cases, including 82.6% of positive cases and 41.6% of negative cases.ED patients were able to reliably collect, perform, and interpret their own POC TV test using tablet instructions. Both participants and providers reported high levels of acceptability of POC TV testing, which nearly doubled rates of TV detection.

Characterizing Emerging Canine H3 Influenza Viruses.

The continual emergence of novel influenza A strains from non-human hosts requires constant vigilance and the need for ongoing research to identify strains that may pose a human public health risk. Since 1999, canine H3 influenza A viruses (CIVs) have caused many thousands or millions of respiratory infections in dogs in the United States. While no human infections with CIVs have been reported to date, these viruses could pose a zoonotic risk. In these studies, the National Institutes of Allergy and Infectious Diseases (NIAID) Centers of Excellence for Influenza Research and Surveillance (CEIRS) network collaboratively demonstrated that CIVs replicated in some primary human cells and transmitted effectively in mammalian models. While people born after 1970 had little or no pre-existing humoral immunity against CIVs, the viruses were sensitive to existing antivirals and we identified a panel of H3 cross-reactive human monoclonal antibodies (hmAbs) that could have prophylactic and/or therapeutic value. Our data predict these CIVs posed a low risk to humans. Importantly, we showed that the CEIRS network could work together to provide basic research information important for characterizing emerging influenza viruses, although there were valuable lessons learned.

Informed consent for opt-in HIV testing via tablet kiosk: an assessment of patient comprehension and acceptability.

Although implementation of HIV testing in the emergency department has met with some success, one commonly cited challenge is the consent process. Kiosks offer one potential strategy to overcome this barrier. This pilot cross-sectional survey study examined patient comprehension of opt-in HIV testing consent and acceptability of using a kiosk to provide consent. Subjects were guided through a simulated consent process using a kiosk and then completed a survey of consent comprehension and acceptability of kiosk use. Subjects were 50.3% female, Black (74.4%), and had an education level of high school or less (61.3%). Subjects found the kiosk very easy or easy to use (83.9%) and reported they were very or mostly comfortable using the kiosk to consent to HIV testing (89.4%). Subjects understood the required aspects of consent: HIV testing was voluntary (93.0%, n = 185) and that refusal would not impact their care (98.5%, n = 196; 99.0%, n = 197). Following a simulated consent process, subjects demonstrated a high rate of comprehension about the vital components of HIV testing consent. Subjects reported they were comfortable using the kiosk, found the kiosk easy to use, and reported a positive experience using the kiosk to provide consent for HIV testing.