Odesanmi Tolulope Y, Wasti Sharada P, Odesanmi Omolola S, Adegbola Omololu, Oguntuase Olubukola O, Mahmood Sajid
School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK.
Sex Health. 2013 Dec;10(6):559-69. doi: 10.1071/SH13029.
Home-based sampling is a strategy to enhance uptake of sexually transmissible infection (STI) screening. This review aimed to compare the screening uptake levels of home-based self-sampling and clinic-based specimen collection for STIs (chlamydia (Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae) and trichomoniasis) in females aged 14-50 years. Acceptability and effect on specimen quality were determined.
Sixteen electronic databases were searched from inception to September 2012. Randomised controlled trials (RCTs) comparing the uptake levels of home-based self-sampling and clinic-based sampling for chlamydia, gonorrhoea and trichomoniasis in females aged 14-50 years were eligible for inclusion. The risk of bias in the trials was assessed. Risk ratios (RRs) for dichotomous outcomes were meta-analysed.
Of 3065 papers, six studies with seven RCTs contributed to the final review. Compared with clinic-based methods, home-based screening increased uptake significantly (P=0.001-0.05) in five trials and was substantiated in a meta-analysis (RR: 1.55; 95% confidence interval: 1.30-1.85; P=0.00001) of two trials. In three trials, a significant preference for home-based testing (P=0.001-0.05) was expressed. No significant difference was observed in specimen quality. Sampling was rated as easy by a significantly higher number of women (P=0.01) in the clinic group in one trial.
The review provides evidence that home-based testing results in greater uptake of STI screening in females (14-50 years) than clinic-based testing without compromising quality in the developed world. Home collection strategies should be added to clinic-based screening programs to enhance uptake.
家庭采样是一种提高性传播感染（STI）筛查接受率的策略。本综述旨在比较14至50岁女性中，基于家庭的自我采样和基于诊所的标本采集用于性传播感染（衣原体（沙眼衣原体）、淋病（淋病奈瑟菌）和滴虫病）的筛查接受水平。确定了可接受性和对标本质量的影响。
检索了从数据库建立至2012年9月的16个电子数据库。比较14至50岁女性中基于家庭的自我采样和基于诊所的采样用于衣原体、淋病和滴虫病筛查接受水平的随机对照试验（RCT）符合纳入标准。评估了试验中的偏倚风险。对二分类结局的风险比（RR）进行了荟萃分析。
在3065篇论文中，六项研究及七项随机对照试验纳入了最终综述。与基于诊所的方法相比，在五项试验中，基于家庭的筛查显著提高了接受率（P = 0.001 - 0.05），并在两项试验的荟萃分析中得到证实（RR：1.55；95%置信区间：1.30 - 1.85；P = 0.00001）。在三项试验中，表达了对基于家庭检测的显著偏好（P = 0.001 - 0.05）。在标本质量方面未观察到显著差异。在一项试验中，诊所组中显著更多的女性将采样评为容易（P = 0.01）。
该综述提供的证据表明，在发达国家，基于家庭的检测比基于诊所的检测能使（14至50岁）女性对性传播感染筛查的接受率更高，且不影响质量。应将家庭采集策略添加到基于诊所的筛查项目中以提高接受率。
