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希腊移民性传播感染的即时诊断

Point-of-care diagnostics for sexually transmitted infections among migrants in Greece.

作者信息

Tsorou C, Williams A, van den Boogaard W, Staderini N, Repetto E, Terzidis A, Pikoulis E

机构信息

Médecins Sans Frontières (MSF), Operational Centre Geneva, Mission Greece, Athens.

Disaster Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Public Health Action. 2024 Mar 1;14(1):14-19. doi: 10.5588/pha.23.0022. eCollection 2024 Mar.

Abstract

SETTING

Sexually transmitted infections (STIs) can impact individuals of any demographic. The most common pathogens causing STIs are , and ; these can be treated with specific antibiotics.

OBJECTIVE

To compare the GeneXpert CT/NG test-and-treat algorithm to the syndromic approach algorithm and their impact on antibiotic prescription for gonorrhoea and chlamydia STIs.

DESIGN

A retrospective observational study on women aged ≥18 years who accessed the Médecins Sans Frontières Day Care Centre in Athens with complaints related to urogenital infections between January 2021 and March 2022. Women with abnormal vaginal discharge, excluding clinically diagnosed candidiasis, were eligible for Xpert CT/NG testing.

RESULTS

Of the 450 women who accessed care, 84 were eligible for Xpert CT/NG testing, and only one was positive for chlamydia, therefore resulting in saving 81 doses of ceftriaxone and azithromycin, and 19 doses of metronidazole. The cost of Xpert CT/NG testing, including treatment was €4,606.37, while full antibiotic treatment would have costed €536.76.

CONCLUSION

The overall cost of the Xpert CT/NG test-and-treat algorithm was higher than the syndromic approach. However, quality of care should be weighed against the potential benefits of testing and syndromic treatment to determine the best option for each patient; we therefore advocate for decreasing the costs.

摘要

背景

性传播感染(STIs)可影响任何人口统计学特征的个体。引起性传播感染的最常见病原体是淋病奈瑟菌、沙眼衣原体和梅毒螺旋体;这些病原体可用特定抗生素治疗。

目的

比较GeneXpert CT/NG检测与治疗算法和症状法算法及其对淋病和衣原体性传播感染抗生素处方的影响。

设计

一项回顾性观察研究,对象为2021年1月至2022年3月期间因泌尿生殖系统感染相关主诉前往雅典无国界医生日托中心就诊的≥18岁女性。有异常阴道分泌物(不包括临床诊断的念珠菌病)的女性有资格接受Xpert CT/NG检测。

结果

在450名接受治疗的女性中,84名有资格接受Xpert CT/NG检测,只有1名衣原体检测呈阳性,因此节省了81剂头孢曲松和阿奇霉素以及19剂甲硝唑。Xpert CT/NG检测(包括治疗)的费用为4606.37欧元,而全程抗生素治疗的费用为536.76欧元。

结论

Xpert CT/NG检测与治疗算法的总体成本高于症状法。然而,应权衡护理质量与检测和症状治疗的潜在益处,以确定每位患者的最佳选择;因此,我们主张降低成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef44/11122709/28e227bb5a41/pha0022f1.jpg

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