scholarly journals A portable magnetofluidic platform for detecting sexually transmitted infections and antimicrobial susceptibility

2021 ◽  
Vol 13 (593) ◽  
pp. eabf6356
Author(s):  
Alexander Y. Trick ◽  
Johan H. Melendez ◽  
Fan-En Chen ◽  
Liben Chen ◽  
Annet Onzia ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Magnetic Beads ◽  
Point Of Care ◽  
Low Cost ◽  
Nucleic Acid Amplification ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Automated Processing ◽  
Analysis Of Results ◽  
Sexual Health Clinics

Effective treatment of sexually transmitted infections (STIs) is limited by diagnostics that cannot deliver results rapidly while the patient is still in the clinic. The gold standard methods for identification of STIs are nucleic acid amplification tests (NAATs), which are too expensive for widespread use and have lengthy turnaround times. To address the need for fast and affordable diagnostics, we have developed a portable, rapid, on-cartridge magnetofluidic purification and testing (PROMPT) polymerase chain reaction (PCR) test. We show that it can detect Neisseria gonorrhoeae, the pathogen causing gonorrhea, with simultaneous genotyping of the pathogen for resistance to the antimicrobial drug ciprofloxacin in <15 min. The duplex test was integrated into a low-cost thermoplastic cartridge with automated processing of penile swab samples from patients using magnetic beads. A compact instrument conducted DNA extraction, PCR, and analysis of results while relaying data to the user via a smartphone app. This platform was tested on penile swab samples from sexual health clinics in Baltimore, MD, USA (n = 66) and Kampala, Uganda (n = 151) with an overall sensitivity and specificity of 97.7% (95% CI, 94.7 to 100%) and 97.6% (95% CI, 94.1 to 100%), respectively, for N. gonorrhoeae detection and 100% concordance with culture results for ciprofloxacin resistance. This study paves the way for delivering accessible PCR diagnostics for rapidly detecting STIs at the point of care, helping to guide treatment decisions and combat the rise of antimicrobial resistant pathogens.

scholarly journals Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
E. Morikawa ◽  
M. Mudau ◽  
D. Olivier ◽  
L. de Vos ◽  
D. Joseph Davey ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
South African ◽  
Trichomonas Vaginalis ◽  
Point Of Care ◽  
Diagnostic Testing ◽  
Nucleic Acid Amplification ◽  
National Guidelines ◽  
Sexually Transmitted

Background. Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infections may increase the risk of vertical transmission of the human immunodeficiency virus (HIV). In resource-limited settings, symptomatic screening, and syndromic management of sexually transmitted infections (STIs) during pregnancy continue to be the standard of care. In the absence of diagnostic testing, asymptomatic infections in pregnant women go untreated. Objective. To describe the acceptability and feasibility of integrating diagnostic STI screening into first antenatal care visits for HIV-infected pregnant women. Methods. HIV-infected pregnant women were recruited during their first antenatal care visit from three antenatal care clinics in Tshwane District, South Africa, between June 2016 and October 2017. Self-collected vaginal swabs were used to screen for CT, NG, and TV with a diagnostic point-of-care (POC) nucleic acid amplification test. Those with STIs were provided treatment per South African national guidelines. Results. Of 442 eligible women, 430 (97.3%) agreed to participate and were tested. Of those with a positive STI test result (n = 173; 40.2%), 159 (91.9%) received same-day results and treatment; 100% of STI-infected women were treated within seven days. Conclusions. Integration of POC diagnostic STI screening into first-visit antenatal care services was feasible and highly acceptable for HIV-infected pregnant women.

scholarly journals Using the behaviour change wheel approach to optimise self-sampling packs for sexually transmitted infections and blood borne viruses

2021 ◽  
Author(s):  
Paul Flowers ◽  
Gabriele Vojt ◽  
Maria Pothoulaki ◽  
Fiona Mapp ◽  
Melvina Woode-Owusu ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Behaviour Change Techniques ◽  
Behaviour Change Technique ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Behaviour Change Wheel ◽  
Qualitative Work ◽  
Sexual Health Clinics

Purpose: This paper describes the process of optimising a widely offered intervention - the self-sampling pack for sexually transmitted infections (STIs) and blood born viruses (BBVs). We drew upon the BCW approach, incorporating the theoretical domains framework (TDF) and the behaviour change technique taxonomy (BCTT) to systematically specify potential intervention components that may optimise the packs. Methods: A behaviour change wheel analysis built upon prior thematic analyses of qualitative data collected through focus groups and interviews with members of the public and people recruited from sexual health clinics in Glasgow and London (n=56). Salient barriers and facilitators to specific sequential behavioural domains associated with wider behavioural system of pack-use were subjected to further analyses, coding them in relation to the TDF, the BCWs intervention functions, and finally specifying potential optimisation in relation to behaviour change techniques (BCTs). Results: Our TDF analysis suggested that across the overall behavioural system of pack use the most important theoretical domains were beliefs about consequences and memory, attention and decision-making. BCW analysis on the overall pack suggested useful intervention functions should focus on environmental restructuring, persuasion, enablement, education and modelling. Ways of optimising the intervention were also specified in relation to potentially useful behaviour change techniques (BCTs). Conclusions: A detailed behavioural analysis building on earlier qualitative work using the TDF and the BCW provided a systematic approach to optimising an existing intervention. The approach enabled the specification of highly specific, evidence-based, and theoretically informed recommendations for intervention optimisation.

scholarly journals P07.06 A low cost, hand-held point of care molecular diagnostic device for sexually transmitted infections

2015 ◽  
Vol 91 (Suppl 2) ◽  
pp. A122.2-A122
Author(s):  
RE Mackay ◽  
M Branavan ◽  
P Craw ◽  
A Naveenathayalan ◽  
ST Sadiq ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Point Of Care ◽  
Low Cost ◽  
Molecular Diagnostic ◽  
Diagnostic Device ◽  
Sexually Transmitted

scholarly journals Modular development of a prototype point of care molecular diagnostic platform for sexually transmitted infections

2016 ◽  
Vol 38 (8) ◽  
pp. 741-748 ◽  
Author(s):  
Manoharanehru Branavan ◽  
Ruth E. Mackay ◽  
Pascal Craw ◽  
Angel Naveenathayalan ◽  
Jeremy C. Ahern ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Point Of Care ◽  
Molecular Diagnostic ◽  
Sexually Transmitted

scholarly journals Is it time to move to nucleic acid amplification tests screening for pharyngeal and rectal gonorrhoea in men who have sex with men to improve gonorrhoea control?

Sexual Health ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 9 ◽  
Author(s):  
Christopher K. Fairley ◽  
Marcus Y. Chen ◽  
Catriona S. Bradshaw ◽  
Sepehr N. Tabrizi
Keyword(s):  
Nucleic Acid ◽  
Antimicrobial Resistance ◽  
Sexual Health ◽  
Nucleic Acid Amplification ◽  
Nucleic Acid Amplification Tests ◽  
Health Clinics ◽  
Sex With Men ◽  
Sexual Health Clinics

The use of nucleic acid amplification tests (NAAT), as well as or in preference to culture for non-genital sites is now recommended both in Australia and overseas because of their greater sensitivity and improved specificity. A survey of 22 Australian sexual health clinics who each year test over 14 500 men who have sex with men (MSM) show that culture remains the predominate method for detecting gonorrhoea at pharyngeal (64%) and rectal (73%) sites. This editorial discusses the potential disadvantages of using culture over NAAT in relation to optimal gonorrhoea control among MSM and advocates that significantly improved control would be achieved by moving to NAAT with the proviso that culture samples are taken wherever possible on NAAT-positive samples and from clients with urethritis to ensure continued surveillance for antimicrobial resistance.

Genital elephantiasis and sexually transmitted infections – revisited

2006 ◽  
Vol 17 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Somesh Gupta ◽  
C Ajith ◽  
Amrinder J Kanwar ◽  
Virendra N Sehgal ◽  
Bhushan Kumar ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Causative Agent ◽  
Significant Proportion ◽  
Medical Problem ◽  
Nucleic Acid Amplification ◽  
Sexually Transmitted ◽  
Laboratory Facilities ◽  
Laboratory Investigations ◽  
Polymerase Chain ◽  
The Tropics

Genital elephantiasis is an important medical problem in the tropics. It usually affects young and productive age group, and is associated with physical disability and extreme mental anguish. The majority of cases are due to filariasis; however, a small but significant proportion of patients develop genital elephantiasis due to bacterial sexually transmitted infections (STIs), mainly lymphogranuloma venereum (LGV) and donovanosis. STI-related genital elephantiasis should be differentiated from elephantiasis due to other causes, including filariasis, tuberculosis, haematological malignancies, iatrogenic, or dermatological diseases. Laboratory investigations like microscopy of tissue smear and nucleic acid amplification test for donovanosis, and serology and polymerase chain reaction for LGV may help in the diagnosis, but in endemic areas, in the absence of laboratory facilities, diagnosis largely depends on clinical characteristics. The causative agent of LGV, Chlamydia trachomatis serovar L1–L3, is a lymphotropic organism which leads to the development of thrombolymphangitis and perilymphangitis, and lymphadenitis. Long-standing oedema, fibrosis and lymphogranulomatous infiltration result in the final picture of elephantiasis. Elephantiasis in donovanosis is mainly due to constriction of the lymphatics which are trapped in the chronic granulomatous inflammatory response generated by the causative agent, Calymmatobacterium (Klebsiella) granulomatis. The LGV-associated genital elephantiasis should be treated with a prolonged course of doxycycline given orally, while donovanosis should be treated with azithromycin or trimethoprim-sulphamethoxazole combination given for a minimum of three weeks. Genital elephantiasis is not completely reversible with medical therapy alone and often needs to be reduced surgically.

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