衣原体和淋病产前筛查的可接受性、可行性、公平性及资源利用：一项系统评价

Acceptability, feasibility, equity and resource use for prenatal screening for chlamydia and gonorrhea: A systematic review.

作者信息

Shanmugasegaram Shamila, Auguste Ulrick, Fleurant-Ceelen Annie, Sabourin Stacy, Labbé Annie-Claude, Bullard Jared, Ogilvie Gina, Yudin Mark H, Santesso Nancy

机构信息

Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON.

Hôpital Maisonneuve-Rosemont, Montréal, QC.

出版信息

Can Commun Dis Rep. 2024 Jul 24;50(7-8):250-258. doi: 10.14745/ccdr.v50i78a03. eCollection 2024 Jul-Aug.

DOI:10.14745/ccdr.v50i78a03

PMID:39170589

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11318970/

Abstract

BACKGROUND

A systematic review on acceptability, feasibility, equity and resource use was conducted as part of updating recommendations from the Public Health Agency of Canada on prenatal screening for (CT) and (NG).

METHODS

Information sources, including MEDLINE® All, Embase and Cochrane CENTRAL (January 2003-January 2021) electronic databases were searched for studies that assessed acceptability, feasibility, equity and resource use of screening for CT or NG in pregnant persons aged ≥12 years. The Risk of Bias Assessment Tool for Non-Randomized Studies was used for quality assessment and a narrative synthesis was prepared.

RESULTS

Of the 1,386 records identified, nine observational studies (approximately 5,000 participants) and three economic evaluations met the inclusion criteria. In general, pregnant persons and healthcare providers accepted screening. Most pregnant persons and partners supported universal testing for CT. Pregnant persons preferred non-invasive sampling methods. Inequities in feasibility (accessibility to screening) exist in certain populations. Studies have shown that targeted screening can miss cases. Screening all pregnant persons for CT has net cost savings compared to no screening. Limitations include not identifying eligible literature on acceptability of prenatal screening for NG among partners of pregnant persons and some studies with increased risk populations that restrict the generalizability of the findings highlighting areas for future research.

CONCLUSION

Prenatal screening for CT and NG is generally acceptable among pregnant persons and healthcare providers. Evidence has shown that targeted screening can miss cases. The findings were included when updating PHAC's recommendations on prenatal screening for CT and NG. This work was presented at the Society of Obstetricians and Gynaecologists of Canada's 2024 Annual Clinical and Scientific Conference in Edmonton, Alberta.

摘要

背景

作为更新加拿大公共卫生局关于沙眼衣原体（CT）和淋病奈瑟菌（NG）产前筛查建议的一部分，开展了一项关于可接受性、可行性、公平性和资源利用的系统评价。

方法

检索信息来源，包括MEDLINE® All、Embase和Cochrane CENTRAL（2003年1月至2021年1月）电子数据库，以查找评估≥12岁孕妇CT或NG筛查的可接受性、可行性、公平性和资源利用的研究。使用非随机研究的偏倚风险评估工具进行质量评估，并进行叙述性综合分析。

结果

在识别出的1386条记录中，9项观察性研究（约5000名参与者）和3项经济评估符合纳入标准。总体而言，孕妇和医疗保健提供者接受筛查。大多数孕妇和伴侣支持对CT进行普遍检测。孕妇更喜欢非侵入性采样方法。某些人群存在可行性方面的不平等（筛查可及性）。研究表明，针对性筛查可能会漏诊病例。与不进行筛查相比，对所有孕妇进行CT筛查可节省净成本。局限性包括未识别出关于孕妇伴侣中NG产前筛查可接受性的合格文献，以及一些针对高危人群的研究限制了研究结果的普遍性，突出了未来研究的领域。