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[用于检测沙眼衣原体和淋病奈瑟菌的全国分子检测网络:巴西的试点实施经验]

[A national network of molecular tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae: a pilot implementation experience in Brazil].

作者信息

Gaspar Pâmela Cristina, Miranda Angélica Espinosa, Bigolin Alisson, Morais Amanda Alencar Cabral, Aragón Mayra Gonçalves, Morais José Athayde Vasconcelos, Alonso Neto José Boullosa, Lannoy Leonor Henriette de, Sanchez Mauro Niskier, Cravo Neto Draurio Barreira, Bermúdez Ximena Pamela Claudia Díaz, Benzaken Adele Schwartz

机构信息

Departamento de HIV/AIDS, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis, Ministério da Saúde, Brasília, Brasil.

Programa de Pós-graduação em Saúde Coletiva, Universidade de Brasília, Brasília, Brasil.

出版信息

Cad Saude Publica. 2024 Jul 29;40(7):e00123023. doi: 10.1590/0102-311XPT123023. eCollection 2024.

Abstract

This study aimed to know the opinion of professionals participating in an experiment to implement a pilot for molecular tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae at the Brazilian Unified National Health System (SUS). The detection rate of C. trachomatis and/or N. gonorrhoeae and the factors associated with infection were determined. The strategy included laboratories belonging to the HIV and viral hepatitis viral load network. Testing targeted people who are more vulnerable to sexually transmitted infections and collected urine samples and/or vaginal, endocervical, and/or male urethral swabs. Questionnaires were sent to state managers and laboratory professionals about the implementation of the pilot. Reviews were overall positive. Weaknesses included difficulties changing work processes, lack of human resources, poorly sensitized care professionals, and absence of primary urine tubes, the only input not provided. Strengths included the centralized acquisition of tests, sharing of equipment, and storage of samples at room temperature. Of the 16,177 people who were tested, 1,004 (6.21%) were positive for C. trachomatis; 1,036 (6.4%), for N. gonorrhoeae; and 239 (1.48%), for C. trachomatis/N. gonorrhoeae . Detection of any infection occurred more frequently in young people (≤ 24 vs. > 24 years) (adjOR = 2.65; 95%CI: 2.38-2.96), men (adjOR = 1.95; 95%CI: 1.72-2.21), brown/black individuals (adjOR = 1.06; 95%CI: 1.05-1.11), those in Southeastern Brazil (adjOR = 1.08; 95%CI: 1.02-1.13), and in urethral secretion samples (adjOR = 1.46; 95%CI: 1.41-1.52). Results show the importance of making testing available nationwide, which supported the implementation of a definitive network to detection C. trachomatis/N. gonorrhoeae in SUS.

摘要

本研究旨在了解参与一项实验的专业人员对于在巴西统一国家卫生系统(SUS)开展分子检测以检测沙眼衣原体和淋病奈瑟菌试点项目的看法。确定了沙眼衣原体和/或淋病奈瑟菌的检出率以及与感染相关的因素。该策略包括属于艾滋病毒和病毒性肝炎病毒载量网络的实验室。检测对象为更易感染性传播感染的人群,并采集尿液样本和/或阴道、宫颈管和/或男性尿道拭子。向州管理人员和实验室专业人员发送了关于试点项目实施情况的问卷。总体评价为积极。不足之处包括工作流程难以改变、人力资源短缺、护理专业人员敏感度低以及缺少主要的尿管(唯一未提供的耗材)。优点包括检测集中采购、设备共享以及样本室温保存。在接受检测的16177人中,1004人(6.21%)沙眼衣原体检测呈阳性;1036人(6.4%)淋病奈瑟菌检测呈阳性;239人(1.48%)沙眼衣原体/淋病奈瑟菌检测呈阳性。任何感染的检测在年轻人(≤24岁与>24岁)中更为常见(调整后比值比=2.65;95%置信区间:2.38 - 2.96),男性(调整后比值比=1.95;95%置信区间:1.72 - 2.21),棕色/黑色人种(调整后比值比=1.06;95%置信区间:1.05 - 1.11),巴西东南部地区的人(调整后比值比=1.08;95%置信区间:1.02 - 1.13),以及尿道分泌物样本中(调整后比值比=1.46;95%置信区间:1.41 - 1.52)。结果表明在全国范围内提供检测的重要性,这为在SUS中建立一个确定的沙眼衣原体/淋病奈瑟菌检测网络提供了支持。

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Sexually Transmitted Infections Treatment Guidelines, 2021.《2021年性传播感染治疗指南》
MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. doi: 10.15585/mmwr.rr7004a1.

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