1
|
Yu X, Zhao P, Mai Z, Xu Q, Chen W, Wu Z, Luo X, Wu Z, Liu X, Wu Q, Zheng H, Xue Y. Evaluation of the Predictive Value of Urine Leukocyte Esterase Test in Chlamydia trachomatis and Neisseria gonorrhoeae Infection Among Males Attending HIV/STI Clinics in Guangdong Province, China. Front Med (Lausanne) 2022; 9:858165. [PMID: 35386911 PMCID: PMC8978786 DOI: 10.3389/fmed.2022.858165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
Leukocyte esterase test (LET) detection is a simple and inexpensive test performed by urinalysis. This study investigated the predictive value of LET for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection among men attending HIV and sexually transmitted infection (HIV/STI) clinics in Guangdong Province, China. A total of 5,509 urine samples were collected from HIV and sexually transmitted infection clinics in Guangdong Province between 2017 and 2019. Specimens from 5,464 males were tested by both LET and nucleic acid amplification test (NAAT). Of 5,464 males, 497 (9.1%) tested positive for CT or NG by NAAT, with respective prevalence rates of 6.4% (95% confidence interval [95% CI]: 5.8-7.1%) and 3.8% (95% CI: 3.3-4.3%), including 1.2% (95% CI: 0.9-1.4%) co-infected. Compared to the HIV-negative individuals, individuals living with HIV tend to have a higher prevalence of CT, NG and co-infection with CT and NG. The LET sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CT were 46.4% (95% CI: 41.2-51.7%), 92.0% (95% CI: 91.2-92.7%), 28.4% (95% CI: 24.8-32.1%), and 96.1% (95% CI: 95.6-96.7%), respectively. The LET sensitivity, specificity, PPV, and NPV for NG were 68.4% (95% CI: 62.1-74.7%), 91.8% (95% CI: 91.1-92.6%), 25.0% (95% CI: 21.4-28.5%), and 98.7% (95% CI: 98.3-99%), respectively. Compared to the HIV-negative individuals, higher sensitivity and specificity were observed for HIV-positive individuals, but there was no statistical difference. The incremental cost-effectiveness ratio (ICER) using economic costs per additional person CT positive and NG positive was -$238.74 and -$145.60 compared with LET positive, respectively. LET is a cost-effective test and will be valuable for predicting CT and NG infection, which is highly prevalent in low- and middle-income countries.
Collapse
Affiliation(s)
- Xueying Yu
- Department of Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou, China.,Department of Clinical Laboratory, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Peizhen Zhao
- Department of Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Zhida Mai
- Department of Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Qingqing Xu
- Department of Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Wentao Chen
- Department of Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Zhiqiao Wu
- Department of Clinical Laboratory, The Sixth People's Hospital of Dongguan, Dongguan, China
| | - Xiaojuan Luo
- Department of Clinical Laboratory, The First People's Hospital of Foshan, Foshan, China
| | - Zhizhou Wu
- Department of Clinical Laboratory, Dermatology Hospital of Jiangmen, Jiangmen, China
| | - Xiaofeng Liu
- Department of Clinical Laboratory, The Third People's Hospital of Zhuhai, Zhuhai, China
| | - Qian Wu
- Department of Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Heping Zheng
- Department of Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Yaohua Xue
- Department of Clinical Laboratory, Dermatology Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
2
|
Naeem F, Karellis A, Nair S, Routy JP, Yansouni CP, Kim J, Pai N. Multiplexed technologies for sexually transmitted infections: global evidence on patient-centered and clinical health outcomes. BMJ Glob Health 2021; 6:bmjgh-2021-005670. [PMID: 34301675 PMCID: PMC8311302 DOI: 10.1136/bmjgh-2021-005670] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/10/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction Conventional care packages around screening for sexually transmitted infections (STIs) entail multiple clinic visits and precipitate losses to follow-up. To prevent these losses, multiplexed technologies for STIs (immunochromatographic tests/devices/assays and molecular assays that can screen multiple pathogens or multiple strains of one STI) can yield same-day results in a single visit. Research evidence of patient-centred (preference, satisfaction) and clinical health outcomes (feasibility, case positivity, uptake, impact) has not been synthesised. We conducted a systematic review to fill this gap. Methods For the period 2009–2020, two independent reviewers searched PubMed and Embase, retrieved 4440 citations and abstracted data from 42 relevant studies. Results Of 42 studies, 10 (23.8%) evaluated multiplexed immunochromatographic and 32 (76.2%) molecular assays. Outcomes were reported as follows: preference (n=3), satisfaction (n=2), uptake (n=1), feasibility (n=2), case positivity (n=42) and impact (n=11). Screened populations included various at-risk groups. A majority (86.1%–92.4%) of participants preferred (60.2%–97.2%) multiplexed technologies (over conventional testing). Compared with conventional lab-based testing, test uptake improved by 99.4% (hepatitis C), 99.6% (Trichomonas vaginalis), 78.6% (hepatitis B) and 42.0% (HIV). Varying case positivities were documented depending on populations screened: HIV (1.8%–29.3%), hepatitis B (1.1%–23.9%), hepatitis C (0.5%–42.2%), Chlamydia trachomatis (2.8%–30.2%), Neisseria gonorrhoeae (0.0%–30.3%) and T. vaginalis (0.0%–32.7%). Regarding impact, 70.0%–100.0% of screened participants were linked to care, with result turnaround times ranging from 14 min (immunochromatographic assays) to 300 min (molecular assays). Conclusions Compared with conventional lab-based testing, rapid multiplexed technologies were preferred by testees and led to quicker turnaround times for many STIs yielding same-day results thereby allowing to initiate rapid linkages to care. They were further shown to be highly feasible and impactful for detection and treatment facilitation. Based on these promising results, multiplexed technologies offer potential to screen at-risk populations to reduce onward STI transmission worldwide.
Collapse
Affiliation(s)
- Faheel Naeem
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,CORE, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Angela Karellis
- Department of Medicine, McGill University, Montreal, Quebec, Canada.,CORE, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Suma Nair
- Community Medicine, Kasturba Medical College Manipal, Manipal, Karnataka, India
| | - Jean-Pierre Routy
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada
| | - Cédric Philippe Yansouni
- J D MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Quebec, Canada.,Division of Infectious Diseases and Department of Microbiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - John Kim
- National Laboratory for HIV Reference Services, Public Health Agency of Canada, Winnipeg, Quebec, Canada
| | - Nitika Pai
- Department of Medicine, McGill University, Montreal, Quebec, Canada .,CORE, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| |
Collapse
|
3
|
O'Brien KS, Chernet A, Moncada J, Schachter J, Emerson PM, Nash SD, Chanyalew M, Tadesse Z, Zhou Z, McCulloch CE, Lietman TM, Keenan JD. Precision of the Abbott RealTime Assay in the Detection of Ocular Chlamydia trachomatis in a Trachoma-Endemic Area of Ethiopia. Am J Trop Med Hyg 2020; 103:234-237. [PMID: 32394877 DOI: 10.4269/ajtmh.19-0695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Nucleic acid amplification tests are increasingly used to detect ocular chlamydia infection in trachoma research and programs. To evaluate the reliability of Chlamydia trachomatis detection by the Abbott RealTime CT/NG assay (Abbott Molecular, Inc., Des Plaines, IL) on the m2000 platform, three conjunctival samples were collected from each of 200 children aged 0-9 years in Ethiopia: two from the right eye and one from the left eye. Four aliquots were processed for each child: two from the first right eye sample, one from the second right eye sample, and one from the left eye sample. Sixty-nine swabs were processed in a U.S. laboratory and 131 in an Ethiopian laboratory. Intra-class correlation coefficients (ICCs) were high when comparing two aliquots from the same swab (ICC ranged from 0.96 to 0.99), two separate swabs from the right eye (0.89-0.91), and one right and one left eye swab (0.87-0.89), indicating reliable chlamydial load assessment across different samples and laboratory settings.
Collapse
Affiliation(s)
- Kieran S O'Brien
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California.,Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
| | | | - Jeanne Moncada
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California
| | - Julius Schachter
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California
| | | | | | | | | | - Zhaoxia Zhou
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Thomas M Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.,Department of Ophthalmology, University of California, San Francisco, San Francisco, California.,Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California
| | - Jeremy D Keenan
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California.,Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| |
Collapse
|
4
|
Evaluation of a Hydrogel-Based Diagnostic Approach for the Point-of-Care Based Detection of Neisseria gonorrhoeae. Antibiotics (Basel) 2018; 7:antibiotics7030070. [PMID: 30081551 PMCID: PMC6164196 DOI: 10.3390/antibiotics7030070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 11/18/2022] Open
Abstract
Eleven primer pairs were developed for the identification of Neisseria gonorrhoeae. The sensitivity and specificity of these primers were evaluated by Real Time (RT)-PCR melt curve analyses with DNA from 145 N. gonorrhoeae isolates and 40 other Neisseria or non-Neisseria species. Three primer pairs were further evaluated in a hydrogel-based RT-PCR detection platform, using DNA extracted from 50 N. gonorrhoeae cultures. We observed 100% sensitivity and specificity in the hydrogel assay, confirming its potential as a point-of-care test (POCT) for N. gonorrhoeae diagnosis.
Collapse
|
5
|
Xue Y, Zheng H, Tang W, Mai Z, Huang J, Huang S, Qin X, Chen L, Zheng L. Prevalence and Genotype Distribution of Chlamydia trachomatis in Urine among Men Attending Sexually Transmitted Disease Clinics in Guangdong Province, China, in 2016. Jpn J Infect Dis 2017; 71:104-108. [PMID: 29279452 DOI: 10.7883/yoken.jjid.2017.358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Studies have rarely assessed the genotype distribution of Chlamydia trachomatis (CT) in urine among men attending sexually transmitted disease clinics (MSCs) in China. This study was aimed at investigating the prevalence and molecular epidemiology of CT infection by examining urine samples among MSCs from different geographic areas of Guangdong Province, China. A cross-sectional study was conducted among MSCs from 10 human immunodeficiency virus sentinel surveillance sites in Guangdong Province. CT DNA was extracted from male urine samples and analyzed using a Roche cobas 4800 CT/NG. The ompA genes were amplified by nested PCR and sequenced. The leukocyte esterase test was performed by routine urine analysis at local clinics. Of the 1,903 samples, 163 (8.6%, 95% confidence interval [CI] 3.8-16.3%) tested positive for CT. The highest prevalence (10.5%) of CT infection was observed among participants aged between 21 and 30 years. A total of 130 CT-positive samples (79.8%, 130/163) were successfully genotyped by nested PCR, resulting in 8 genotypes. The most prevalent genotypes were D, E, F, and J, with proportions of 20.8%, 20.0%, 17.7%, and 16.9%, respectively. There were no significant correlations between the geographical areas, leukocyte esterase test results and genotype distribution. Promotion of detection and molecular epidemiology research is needed for effective and comprehensive prevention and control programs.
Collapse
Affiliation(s)
- Yaohua Xue
- Department of Clinical Laboratory, Nanfang Hospital, Southern Medical University/ The First School of Clinical Medicine, Southern Medical University.,Department of Research Center, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital
| | - Heping Zheng
- Department of Research Center, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital
| | - Weiming Tang
- SESH Research Team at the School of Medicine, University of North Carolina at Chapel Hill Project-China
| | - Zhida Mai
- Department of Research Center, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital
| | - Jinmei Huang
- Department of Research Center, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital
| | - Shujie Huang
- Department of Research Center, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital
| | - Xiaolin Qin
- Department of Research Center, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital
| | - Lei Chen
- Department of Research Center, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital
| | - Lei Zheng
- Department of Clinical Laboratory, Nanfang Hospital, Southern Medical University/ The First School of Clinical Medicine, Southern Medical University
| |
Collapse
|
6
|
Diagnostic Approaches to Genitourinary Tract Infections. Mol Microbiol 2016. [DOI: 10.1128/9781555819071.ch28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|