Performance and pre-analytical stability of self-collected samples versus clinician cervical samples for the detection of HPV16, HPV18 and a pool of 12 other HPV types on the Roche Cobas 8800 System

This study aimed to validate the agreement between human papillomavirus (HPV) tests self-collected samples versus clinician cervical specimens, and the pre-analytical stability of self-sampling. One hundred and fifty-seven women aged between 25 and 65 years who presented to the gynaecological department of the "CLEMENTVILLE" clinic in Montpellier voluntarily participated in HPV screening by self-sampling. Polymerase chain reaction was used to detect the presence of HPV16, HPV18 and a pool of 12 other HPV types on the Roche Cobas 8800 System. Median age was 40 years (range 20-73 and IQR 31-49 years). The overall HPV prevalence on the population studied was 27%. The agreement between clinician cervical samples and self-collected vaginal presented good agreement (Kappa =0.90) and high sensitivity (0.91) and specificity (0.98). For swabs stored for 7 days at room temperature, the HPV results presented substantial agreement (Kappa =0.89) and high sensitivity (0.97) and specificity (0.93). Our data showed that the HPV assay performed in the self-collected vaginal samples have high consistency of results with the clinician cervical samples. The use of self-collected cervical sample could be a simple and inexpensive approach in cervical cancer screening programs due to their high pre-analytical stability.

The Italian Mandatory Notification System: An Important Public Health Tool For Continuous Monitoring Of Infectious Diseases

Infectious diseases still register significant morbidity and mortality worldwide. Surveillance through a mandatory notification system allows the continuous analysis of the situation even at a local level and its importance has been highlighted by the recent COVID-19 pandemic. This paper aimed to outline the importance of the mandatory notification system as a Public Health tool in the continuous monitoring of infectious diseases. To this aim, we carried out a cross-sectional study examining the notifications reported in the Italian territory of Messina, Sicily, in the period 2001-2020. The institutional websites were examined and the notification data were used to obtain the incidences. Overall, a significant reduction of the incidence notification trend was observed. Chickenpox was by far the most notified infectious disease, followed by scabies, pediculosis, and brucellosis. Outbreaks of brucellosis, measles and hepatitis A occurred. All the diseases decreased over time, except syphilis, for which a significant increase was observed. Surveillance of infectious diseases through a mandatory notification system remains a bulwark of public health despite underreporting. Our study reflects the situation of a typical high-income area, although some unexpected criticisms are highlighted. Continuous information about correct behaviors through education campaigns are crucial in order to improve the situation. Keywords: mandatory notifications, infectious diseases, surveillance, public health Corresponding author: Alessio Facciolà, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy. Email: afacciola@unime.it.

Evaluation of self-collected vaginal specimens for the detection of high-risk human papillomavirus infection and the prediction of high-grade cervical intraepithelial lesions in a high-burden, low-resource setting

OBJECTIVES

To compare the performance of self-collected vaginal (V) specimens with clinician-collected cervical (C) specimens for detection of high-risk human papillomavirus (hrHPV) and cervical disease using the Cepheid Xpert HPV, Roche Cobas 4800 HPV and Hologic Aptima HPV assays.

METHODS

Women aged 30-59 years (n = 1005) were recruited at two clinics in Papua New Guinea, and they provided specimens for testing at point-of-care using the Xpert HPV Test, and for subsequent testing using the Cobas HPV (n = 981) and Aptima HPV (n = 983) assays. Liquid-based cytology was performed on C specimens to predict underlying high-grade squamous intraepithelial lesions (HSIL). V specimen results of each assay were evaluated against a constructed reference standard and for detection of HSIL or worse.

RESULTS

There was substantial (κ >0.6) agreement in hrHPV detection between V and C specimens across all three assays. The sensitivity, specificity, and positive and negative predictive values of Xpert HPV using self-collected V specimens for the detection of HPV type 16 according to the constructed reference standard were 92.1%, 93.1%, 63.6% and 98.9%, respectively; compared with 90.4%, 94.3%, 67.8% and 98.7% for Cobas 4800 HPV; and 63.2%, 97.2%, 75.0% and 95.3% for Aptima HPV. Similar results were observed for all hrHPV types (combined) and for HPV types 18/45, on all three assays. The detection of any hrHPV using self-collected specimens had high sensitivity (86%-92%), specificity (87%-94%) and negative predictive value (>98%) on all assays for HSIL positivity.

CONCLUSIONS

Xpert HPV, using self-collected vaginal specimens, has sufficient accuracy for use in point-of-care 'test-and-treat' cervical screening strategies in high-burden, low-resource settings.