PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
Sex Transm Infect. 2019 Nov;95(7):534-539. doi: 10.1136/sextrans-2018-053835. Epub 2019 Apr 13.
Comprehensive data on (CT) and (NG) infections to guide screening services among transgender women (TGW) are limited. We studied the burden of CT/NG infections in pharyngeal, rectal and urethral sites of Thai TGW and determined missed CT/NG diagnoses if selected site screening was performed.
Thai TGW were enrolled to the community-led test and treat cohort. CT/NG screening was performed from pharyngeal swab, rectal swab and urine using nucleic acid amplification test. CT/NG prevalence in each anatomical site was analysed, along with the relationships of CT/NG among the three anatomical sites.
Of 764 TGW included in the analysis, 232 (30.4%) had CT/NG infections at any anatomical site, with an overall incidence of 23.7 per 100 person-years. The most common CT/NG infections by anatomical site were rectal CT (19.5%), rectal NG (9.6%) and pharyngeal NG (8.1%). Among 232 TGW with CT/NG infections at any anatomical site, 22%-94.4% of infections would have been missed if single anatomical site testing was conducted, depending on the selected site. Among 668 TGW who tested negative at pharyngeal site, 20.4% had either rectal or urethral infections. Among 583 TGW who tested negative at the rectal site, 8.7% had either pharyngeal or urethral infections. Among 751 TGW who tested negative at the urethral site, 19.2% had either pharyngeal or rectal infections.
Almost one-third of Thai TGW had CT/NG infections. All-site screening is highly recommended to identify these infections, but if not feasible rectal screening provides the highest yield of CT/NG diagnoses. Affordable molecular technologies and/or CT/NG screening in pooled samples from different anatomical sites are urgently needed.
NCT03580512.
关于衣原体（CT）和淋病奈瑟菌（NG）感染的综合数据有限，难以指导跨性别女性（TGW）的筛查服务。本研究旨在研究泰国 TGW 的咽部、直肠和尿道部位 CT/NG 感染的负担，并确定如果进行选择性部位筛查，会遗漏哪些 CT/NG 感染的诊断。
本研究招募了社区主导的检测和治疗队列中的泰国 TGW。采用核酸扩增试验，对咽拭子、直肠拭子和尿液进行 CT/NG 筛查。分析了每个解剖部位的 CT/NG 流行率，并分析了 CT/NG 在三个解剖部位之间的关系。
在纳入分析的 764 名 TGW 中，232 名（30.4%）在任何解剖部位均有 CT/NG 感染，总感染率为每 100 人年 23.7 例。按解剖部位分类，最常见的 CT/NG 感染依次为直肠 CT（19.5%）、直肠 NG（9.6%）和咽 NG（8.1%）。在 232 名在任何解剖部位有 CT/NG 感染的 TGW 中，如果进行单一解剖部位检测，根据所选部位，22%-94.4%的感染会被遗漏。在 668 名咽拭子检测阴性的 TGW 中，20.4%有直肠或尿道感染。在 583 名直肠拭子检测阴性的 TGW 中，8.7%有咽或尿道感染。在 751 名尿道拭子检测阴性的 TGW 中，19.2%有咽或直肠感染。
近三分之一的泰国 TGW 有 CT/NG 感染。强烈建议进行全部位筛查以发现这些感染，但如果不可行，直肠筛查可提供最高的 CT/NG 诊断率。迫切需要经济实惠的分子技术和/或来自不同解剖部位的混合样本的 CT/NG 筛查。
NCT03580512。
