Attitudes and Perceptions About Disclosing HIV and Syphilis Results Using Smarttest, a Smartphone App Dedicated to Self- and Partner Testing

2021 ◽  
Vol 33 (3) ◽  
pp. 234-248
Author(s):  
Bryan A. Kutner ◽  
Anthony T. Pho ◽  
Javier López-Rios ◽  
Cody Lentz ◽  
Curtis Dolezal ◽  
...  
Keyword(s):  
Partner Notification ◽  
Linkage To Care ◽  
Sexual Partners ◽  
Smartphone App ◽  
Test Results ◽  
Negative Results ◽  
Partner Testing ◽  
Attitudes And Perceptions ◽  
Positive Results ◽  
Test Result

We explored interest in disclosing test results through a smartphone app dedicated to self- and partner testing for HIV/syphilis. Fifty-nine cisgender men and transgender women each participated in an in-person survey and interview. We examined their interests in sharing test results by audience (e.g., partners, physicians) and by positive versus negative test result. Participants wanted the ability to share results, with notable interest in disclosing negative results to sexual partners and on social media and forwarding positive results to physicians. Participants envisioned smartphone sharing as a means to normalize testing, to notify partners of results, and to expedite linkage to care. Some questioned the authenticity of results shared by smartphone, while others voiced optimism that a personalized, authenticated app could ensure the security and veracity of results. Smartphone testing apps for HIV/syphilis may facilitate disclosure, partner notification, and linkage to care, but need to address concerns about the security and veracity of results.

scholarly journals Centrifugation may eliminate false-positive leucocyte esterase strip test results caused by inflammatory arthritis in the diagnosis of knee infection

2020 ◽  
Vol 9 (5) ◽  
pp. 236-241
Author(s):  
Rui Li ◽  
Chi Wang ◽  
Xiao-Jian Ji ◽  
Qing-Yuan Zheng ◽  
Xiang Li ◽  
...  
Keyword(s):  
False Positive ◽  
Inflammatory Arthritis ◽  
Test Results ◽  
Knee Infection ◽  
Negative Results ◽  
Before And After ◽  
Strip Test ◽  
Positive Results ◽  
Test Result ◽  
Colour Chart

Aims The purpose of this study was to validate our hypothesis that centrifugation may eliminate false-positive leucocyte esterase (LE) strip test results caused by autoimmune diseases in the diagnosis of knee infection. Methods Between January 2016 and May 2019, 83 cases, including 33 cases of septic arthritis and 50 cases of aseptic arthritis, were enrolled in this study. To further validate our hypothesis, another 34 cases of inflammatory arthritis from the Department of Rheumatology of our institution were also included. After aspiration, one drop of synovial fluid was applied to LE strips before and after centrifugation. The results were recorded after approximately three minutes according to the different colour grades on the colour chart. The differences of LE results between each cohort were analyzed. Results Before centrifugation, 46% (23/50) of the LE strip tests in the aseptic arthritis group were false-positives. Most of the false-positive results were due to inflammatory arthritis; after centrifugation, 78.3% (18/23) of the tests yielded negative results. Similar results were observed in cases from the Department of Rheumatology. The sensitivity of the centrifuged LE strip test was 0.818 (0.639 to 0.924), which is still an acceptable level compared with the uncentrifuged results, which yielded a sensitivity of 0.909 (0.745 to 0.976). However, the specificity was increased from 0.540 (0.395 to 0.679) to 0.900 (0.774 to 0.963) after centrifugation. Conclusion Although inflammatory arthritis can yield a false-positive LE strip test result in the diagnosis of knee infection, centrifugation may eliminate these false-positive results. Cite this article: Bone Joint Res. 2020;9(5):236–241.

scholarly journals Treatment of Tuberculosis in South Kazakhstan: Clinical and Economical Aspects

Medicina ◽  
2013 ◽  
Vol 49 (7) ◽  
pp. 52 ◽  
Author(s):  
Talgat Maimakov ◽  
Laura Sadykova ◽  
Zhanna Kalmataeva ◽  
Kural Kurakpaev ◽  
Kastytis Šmigelskas
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Treatment Outcomes ◽  
Financial Resources ◽  
Drug Resistant ◽  
Test Results ◽  
Negative Results ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Positive Treatment ◽  
Positive Results

Background and Objective. Since 1990, the tuberculosis incidence rate in Eastern Europe and post-Soviet republics has been increasing in many countries including Kazakhstan. This problem is particularly important in Kazakhstan regions with limited financial resources, among them – in South Kazakhstan province. The aim of this study was to investigate the main clinical and antibiotic-related economic aspects of tuberculosis treatment in South Kazakhstan province. Material and Methods. In total, 502 patients participated in the study. They were hospitalized to the tuberculosis dispensary of Sayram district (South Kazakhstan province) in 2007–2013. Statistical analysis included logistic regression for better treatment outcomes and analysis of antibiotic treatment costs. Results. Two-thirds of patients had infiltrative tuberculosis (67%). Positive treatment outcomes were determined in 85% of cases. The patients were mostly treated with cycloserine, protionamide, capreomycin, and ofloxacin. The majority of antibiotic costs were related to the treatment with capreomycin. In case of the positive results of the test for Mycobacterium tuberculosis, antibiotic expenses were almost 3 times greater than in case of negative test results (P<0.001). Conclusions. The majority of patients had extensively drug-resistant tuberculosis. The negative results of the test for Mycobacterium tuberculosis at discharge were not related to pretreatment factors. Antibiotic-related costs were significantly higher in case of the positive results of the test of Mycobacterium tuberculosis, but were not associated with gender, residence place, hospitalization recurrence, or main blood test results before treatment.

scholarly journals Early observations from the HIV self-testing program among key populations and sexual partners of pregnant mothers in Kampala, Uganda: A cross sectional study

2022 ◽  
Vol 2 (1) ◽  
pp. e0000120
Author(s):  
Esther Nasuuna ◽  
Florence Namimbi ◽  
Patience A. Muwanguzi ◽  
Donna Kabatesi ◽  
Madina Apolot ◽  
...  
Keyword(s):  
Sex Workers ◽  
Linkage To Care ◽  
Sexual Partners ◽  
Phone Call ◽  
Hiv Positive ◽  
Key Populations ◽  
Cross Sectional ◽  
Confirmatory Testing ◽  
Self Testing ◽  
Positive Results

Background HIV self-testing (HIVST) was adopted for key populations (KPs) and sexual partners of pregnant and lactating women (mothers) in Uganda in October 2018. We report early observations during HIVST implementation in Kampala, Uganda. Methods HIVST was rolled out to reach those with unknown HIV status at 38 public health facilities, using peer-to-peer community-based distribution for female sex workers (FSW) and men who have sex with men (MSM) and secondary distribution for mothers, who gave HIVST kits to their partners. Self-testers were asked to report results within 2 days; those who did not report received a follow-up phone call from a trained health worker. Those with HIV-positive results were offered confirmatory testing at the facility using the standard HIV-testing algorithm. Data on kits distributed, testing yield, and linkage to care were analysed. Results We distributed 9,378 HIVST kits. Mothers received 5,212 (56%) for their sexual partners while KPs received 4,166 (44%) (MSM, 2192 [53%]; FSW1, 974, [47%]). Of all kits distributed, 252 (3%) individuals had HIV-positive results; 126 (6.5%) FSW, 52 (2.3%) MSM and 74 (1.4%) partners of mothers. Out of 252 individuals who had HIV-positive results, 170 (67%) were confirmed HIV-positive; 36 (2%) were partners of mothers, 99 (58%) were FSW, and 35 (21%) were MSM. Linkage to treatment (126) was 74%. Conclusions HIVST efficiently reached, tested, identified and modestly linked to care HIV positive FSW, MSM, and partners of mothers. However, further barriers to confirmatory testing and linkage to care for HIV-positive self-testers remain unexplored.

scholarly journals Cushing’s Disease: The Relevance of a Combined Dexamethasone Desmopressin Test as a Component of Postoperative Hormonal Evaluation

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Przemysław Witek ◽  
Grzegorz Zieliński ◽  
Katarzyna Szamotulska
Keyword(s):  
Cushing’S Disease ◽  
Adrenal Function ◽  
Cushing's Disease ◽  
Test Results ◽  
Negative Results ◽  
Cortisol Levels ◽  
Hormonal Evaluation ◽  
Positive Results ◽  
Time Point

Background. The risk of Cushing’s disease (CD) recurring may persist for years, even after initially successful surgery.Objective. To prospectively assess the relevance of a combined dexamethasone desmopressin test (CDDT) as a component of postoperative hormonal evaluation, including the dynamics of ACTH and cortisol concentrations.Material and Methods. We included 28 patients after TSS for CD. Eighteen months after surgery the standard hormonal evaluation was performed, followed by a CDDT.Results. Fifteen patients (53.6%) were in remission whereas in 13 subjects (46.4%) hypercortisolemia was confirmed. Positive results of CDDT were observed in 12 noncured patients (92.3%) and in one subject in remission (6.7%). Negative results were obtained in 12 patients with remission (80%) and in one noncured patient (7.7%). With 2 patients in CD remission (13.3%) the test results were inconclusive. We confirmed a high compatibility between CDDT and standard hormonal assessment results (κ=0.846;P<0.001). Significant differences in ACTH and cortisol levels at each CDDT time point between the two studied subgroups were shown.Conclusions. A negative CDDT result can be regarded as one of the factors indicative of CD remission during follow-up. Additionally, CDDT can help distinguish persistent hypercortisolemia from naturally recurring adrenal function after TSS.

scholarly journals Serology in COVID-19: Comparison of Two Methods

2021 ◽  
Vol 18 (12) ◽  
pp. 6497
Author(s):  
Anna Moniuszko-Malinowska ◽  
Wojciech Jelski ◽  
Justyna Dunaj ◽  
Barbara Mroczko ◽  
Piotr Czupryna ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Nucleocapsid Protein ◽  
Spike Protein ◽  
Serological Tests ◽  
Negative Results ◽  
Positive Results ◽  
Test Result

Background: The aim of our study was to examine the performance of two assays in detecting SARS-CoV-2 antibodies. Methods: A total of 127 COVID-19 disease contacts from the Infectious Diseases Department were included. Two serological tests were used: SARS-CoV-2 IgG CMIA on the Alinity system (Abbott) and LIAISON® SARS-CoV-2 S1/S2 IgG CLIA (DiaSorin). Results: The assays exhibited a 96.85% (123/127 patients) test result agreement. In two cases, the positive results obtained by SARS-CoV-2 IgG CMIA on the Alinity system (Abbott) were negative based on the LIAISON® SARS-CoV-2 S1/S2 IgG CLIA (DiaSorin) test, and in two cases, negative results from the LIAISON® SARS-CoV-2 S1/S2 IgG CLIA (DiaSorin) test were positive with the SARS-CoV-2 IgG CMIA on the Alinity system (Abbott). Conclusions: Based on the results of our study, we conclude that in population medicine, the assessments of anti-SARS-CoV-2 antibodies after exposure to SARS-CoV-2 virus based on spike protein or nucleocapsid protein show comparable effectiveness.

scholarly journals Optimizing COVID-19 Symptom Screening in the Pediatric Population

2021 ◽  
Vol 1 (S1) ◽  
pp. s55-s56
Author(s):  
Geena Zhou ◽  
Prachi Singh ◽  
Emily R. Perito ◽  
Naomi Bardach ◽  
Nicole Penwill ◽  
...  
Keyword(s):  
Nasal Congestion ◽  
Pediatric Population ◽  
Test Results ◽  
Runny Nose ◽  
Negative Results ◽  
Symptom Screening ◽  
Screening Questionnaires ◽  
Important Symptom ◽  
Outpatient Settings ◽  
Test Result

Background: Research analyzing COVID-19 symptom screening has primarily focused on adult patients. In efforts to safely reopen schools, symptom screeners are being widely utilized. However, pediatric-specific outpatient data on which symptom combinations best identify children with COVID-19 are lacking. Such data could refine school symptom screening by improving screener sensitivity and specificity. In this study, we assessed the frequency of symptoms and symptom combinations in children tested for SARS-CoV-2 in outpatient settings. We aim to contribute to the optimization of pediatric COVID-19 screening questionnaires, to ultimately minimize both COVID-19 transmission in schools and missed school days. Methods: We conducted a retrospective analysis of outpatient symptoms screens, SARS-CoV-2 test results, and demographics of children (≤18 years) tested for SARS-CoV-2 between March 30 and November 30, 2020, at 3 UCSF-affiliated COVID-19 outpatient screening clinics in northern California. Those with incomplete symptom screens, >7 days between symptom documentation and test, and invalid test results were excluded. Results: Of 473 children tested at 1 site, 21 children had positive SARs-CoV-2 results and 452 children had negative results (4.4% positivity rate). Moreover, 85.7% of SARS-CoV-2–positive children had a known exposure to COVID-19 (Table 1). Of SARS-CoV-2–positive children, 61.9% had >1 symptom. Also, 52.4% of SARS-CoV-2–positive children had at least 1 symptom (fever, cough, or loss of taste or smell) versus 62.8% of SARS-CoV-2–negative children (Table 2). Runny nose or nasal congestion was the most frequently reported symptom in the SARS-CoV-2–positive group (47.6%) as well as the SARS-CoV-2–negative group (58.6%). Also, 14.3% of SARS-CoV-2–positive children had eye redness or discharge versus 3.1% of SARS-CoV-2–negative children. Isolated runny nose presented in 10.8% of SARS-CoV-2–negative versus 9.5% of SARS-CoV-2–positive children. All children with isolated diarrhea (n = 5), isolated headache (n = 3), and isolated rash (n = 2) tested negative. Preliminary symptom data based on 176 children from a second site showed that 9.9% of symptomatic children had a positive test result. Conclusions: Runny nose or nasal congestion was the most frequently reported symptom in all children tested for SARS-CoV-2. However, isolated runny nose or nasal congestion identified 2 cases of COVID-19 in our cohort. Eye redness or discharge may be an important symptom to screen for COVID-19 in children. Further research with a larger number of positive cases is needed to make conclusions about improving efficiency and efficacy of symptom screeners for COVID-19 in children.Funding: NoDisclosures: None

scholarly journals Assessment of Clinical Ordering Practices of Phosphatidylethanol Monitoring for Alcohol Use at a Large Academic Medical Center

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S11-S12
Author(s):  
Thomas Herb ◽  
Carmen Gherasim ◽  
David Manthei
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Medical Center ◽  
Academic Medical Center ◽  
Test Results ◽  
Negative Results ◽  
Academic Medical ◽  
Term Monitoring ◽  
Positive Results

Abstract Objectives Phosphatidylethanol (PEth) has emerged as a specific biomarker for alcohol use with superior diagnostic values compared to traditional alcohol biomarkers including urinary ethyl glucuronide (uEtG), urinary ethyl sulfate (uEtS), and carbohydrate-deficient transferrin (CDT). PEth can extend the detection window of alcohol use up to 28 days and has been dubbed a “hemoglobin A1c”-like biomarker for alcohol use. Measurement of PEth concentration in the blood has become of increasing interest in a wide variety of clinical settings including transplant evaluation, detection of chronic alcohol consumption and monitoring alcohol abstinence. Availability of PEth testing is currently limited to few reference laboratories; at our institution, PEth quickly became one of the most expensive chemistry/toxicology sendout tests. Few testing guidelines exist for PEth regarding test utilization and time intervals for appropriate repeat testing. This retrospective analysis was conducted evaluating the patterns of PEth ordering to inform best test utilization strategies. Methods A retrospective limited data set of PEth (PEth 16:0/18:1 by LC-MS/MS) test results was obtained from a large academic medical center. Concordance of the positive test results using a cutoff of 20 ng/mL for repeat testing within 7, 14 and 28 days was analyzed. Results 3,739 distinct results from 1,957 patients was obtained. The median age of patients was 57 years (range 19-94). Males accounted for 58.4% (1,142 patients) of the testing. The overall positivity rate was 23.3% (median concentration 188.5 ng/mL), with 52% of positive results suggesting moderate alcohol consumption (20 – 200 ng/mL) while the remaining 48% reflected heavy alcohol consumption or chronic alcohol use (&gt;200 ng/mL). 588 patients (30%) had multiple PEth results, including 150 patients with ≥ 5 results and 36 patients with ≥ 10 results. Long term monitoring of alcohol use in pre- and post- transplant patients (n=36) with ≥ 10 results revealed that 52.7% had all negative results, 5.6% all positive results, and 41.7% with mixed results included a subset (25%) initially positive and subsequently negative results monitored for up to 2 years. Analysis of two consecutive tests ordered within 7 (n=96), 14 (n=205) and 28 days (n=411) revealed that 90%, 82.9% and 83.7% of the results had the same interpretation with an average change in concentration of 15.2 ng/mL 35.9 ng/mL, and 35.4 ng/mL, respectively. Of the 10% observed changes within 7 days, the majority accounted for expected PEth 16:0/18:1 elimination. Conclusions Our data suggests that long-term monitoring of alcohol use with PEth may be helpful in the surveillance of alcohol abstention or alcohol relapse that can assist in prioritizing patients for liver transplant. To improve PEth test utilization (and decrease expensive sendout testing), PEth should not be ordered less than 7 days apart. Instead, recent alcohol use may be monitored with traditional biomarkers (uEtG/uEtS).

scholarly journals Recurrent recurrence of positive SARS-CoV-2 RNA in a COVID-19 patient

2020 ◽  
Author(s):  
Shugang Cao ◽  
Aimei Wu ◽  
Jiaxia Li ◽  
Yuancheng Li ◽  
Mingwu Xia ◽  
...  
Keyword(s):  
Small Proportion ◽  
Clinical Symptoms ◽  
Antiviral Treatment ◽  
Chest Ct ◽  
Test Results ◽  
Case Presentation ◽  
Negative Results ◽  
Discharged Patients ◽  
Discharge Criteria ◽  
Positive Results

Abstract Background: Coronavirus disease 2019 (COVID-19) is a highly infectious disease. A small proportion of discharged patients may become positive again for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, even if they meet the discharge criteria. Herein, we report a rare COVID-19 patient with recurrent recurrence of positive SARS-CoV-2 RNA.Case presentation: A 68-year-old man was admitted due to fever, muscle pain, and fatigue. He was initially diagnosed with COVID-19 according to two consecutive positive results for SARS-CoV-2 RNA plus clinical symptoms and chest CT findings, and was discharged from hospital when meeting the discharge criteria, including two consecutive negative results. He was tested positive for SARS-CoV-2 RNA twice during the quarantine and was hospitalized again. He was asymptomatic then, but IgG and IgM were both positive. He was discharged in the context of four consecutive negative test results for SARS-CoV-2 RNA after antiviral treatment. However, he was tested positive once again on the 3rd and 4th day after the second discharge, although still asymptomatic. IgG and IgM were still positive. After antiviral treatment, the results of SARS-CoV-2 RNA were negative in three consecutive retests, and he was finally discharged and quarantined for further surveillance. Conclusion: This case suggests that a small proportion of convalescent patients may become positive again for SARS-CoV-2 RNA and be a virus carrier.

scholarly journals Immunoblot Assay Using Recombinant Antigens as a Supplemental Test To Confirm the Presence of Antibodies to Trypanosoma cruzi

2007 ◽  
Vol 14 (4) ◽  
pp. 355-361 ◽  
Author(s):  
Kevin Y. Cheng ◽  
Chi-Deu Chang ◽  
Vince A. Salbilla ◽  
Louis V. Kirchhoff ◽  
David A. Leiby ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
False Positive ◽  
Test Results ◽  
Serological Tests ◽  
Assay Sensitivity ◽  
Immunoblot Assay ◽  
Recombinant Antigens ◽  
Persistent Problem ◽  
Negative Results ◽  
Positive Results

ABSTRACT The diagnosis of chronic Chagas' disease is generally made by detecting antibodies to Trypanosoma cruzi. Most conventional serological tests are based on lysates of whole parasites or semipurified antigen fractions from T. cruzi epimastigotes grown in culture. The occurrence of inconclusive and false-positive results has been a persistent problem with the conventional assays, and there is no universally accepted gold standard for confirmation of positive test results. We describe here an immunoblot assay for detecting antibodies to T. cruzi in which four chimeric recombinant antigens (rAgs), designated FP3, FP6, FP10, and TcF, are used as target antigens. Each of these rAgs is composed of several antigenically distinct regions and includes repetitive as well as nonrepetitive sequences. Each rAg is coated as a discrete line on a nitrocellulose strip. Assay sensitivity was assessed by testing 345 specimens known to be positive for antibodies to T. cruzi. All 345 of these samples showed two to four reactive test bands in addition to the three on-board control bands that are on each strip. Assay specificity was determined by testing 500 specimens from random U.S. blood donors, all of which gave negative results. Based on the results obtained in this study, we propose the following scheme for interpretation of test results: (i) no bands or a single test band = a negative result; (ii) two or more test bands with at least one band showing intensity of 1+ or higher = a positive result; and (iii) multiple faint test bands (±) = indeterminate result. Based on this scheme, the prototype immunoblot assay showed sensitivity of 100% (n = 345) and specificity of 100% (n = 500). Additionally, all 269 potentially cross-reacting and T. cruzi antibody-negative specimens tested negative in our immunoblot assay. The rAg-based immunoblot assay has potential as a supplemental test for confirming the presence of antibodies to T. cruzi in blood specimens and for identifying false-positive results obtained with other assays.

scholarly journals Positive results for patients with COVID-19 discharged form hospital in Chongqing, China

2020 ◽  
Author(s):  
Wang Deng ◽  
Tian-wen Guang ◽  
Mei Yang ◽  
Jian-rong Li ◽  
De-peng Jiang ◽  
...  
Keyword(s):  
Clinical Evidence ◽  
Medical Illness ◽  
Test Results ◽  
Rt Pcr ◽  
Pharyngeal Swab ◽  
Viral Nucleic Acid ◽  
Negative Results ◽  
Chronic Medical Illness ◽  
Positive Results

Abstract Background: Since December 2019, over 80,000 patients with coronavirus disease 2019 (COVID-19) have been confirmed in China. With the increasing number of recovered patients, more attention should be paid to the follow-up of these patients. Methods: In the study, 576 patients with COVID-19 discharged from hospital in Chongqing, China from January 24, 2020, to March 10, 2020 were evaluated by viral nucleic acid tests for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) to determine if they could be released from quarantine. Among the 576 patients, 61 patients (10.6%) had positive RT-PCR test results of SARS-CoV-2. We aimed to analyze the demographics, clinical characteristics and treatment of 61 patients.Results: These positive patients were characterized by older age, chronic medical illness and mild conditions. 38 (62.3%) patients who were asymptomatic without abnormalities on chest radiographs were found in the positive with COVID-19. Also, they showed positive results of stool or sputum specimens with negative results of nasal and pharyngeal swab specimens. The median duration of positive result of SARS-CoV-2 was varied from 3 days to 35 days in the patients discharged from hospital with no family member infection. Conclusions: Multi-site screening of SARS-CoV-2 including nasal and pharyngeal swabs, stool and sputum specimens could be considered to improve the diagnosis, treatment and infection control in patients with COVID-19. Our findings provide the important information and clinical evidence for the improved management of patients recovered from COVID-19

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