Melendez Johan H, Muñiz Tirado Adamaris, Onzia Annet, Mande Emmanuel, Hardick Justin P, Parkes-Ratanshi Rosalind, Hamill Matthew M, Manabe Yukari C
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Sex Transm Infect. 2025 May 19;101(4):247-251. doi: 10.1136/sextrans-2024-056330.
Sexually transmitted infections (STIs) are a global health challenge. Testing is not routinely performed in low- and middle-income countries (LMICs), which bear a disproportionate burden of STIs. Self-collected penile-meatal swabs (SCPMS) are an alternative to urine for STI testing, but data from LMICs are limited.
Between October 2019 and September 2020, recruited participants with urethral discharge syndrome at government health facilities in Kampala, Uganda, provided urine and SCPMS. Samples were retrospectively analysed for (CT), (NG), (MG) and (TV) using Aptima assays. Paired SCPMS and urine samples with discordant STI results were analysed using real-time PCR assays.
Of the 250 participants, 66.8% (n=167), 22.8% (n=57), 12.8% (n=32) and 2.4% (n=6) tested positive for NG, CT, MG and TV, respectively, on testing of their SCPMS and urine samples. The overall agreement between urine and SCPMS for all STIs using the Aptima assays was 98.7% (987/1000). After adjudication with PCR assays, the agreement between urine and SCPMS for NG, CT, MG and TV was 100% (250/250), 97.6% (244/250), 99.6% (249/250), and 99.6% (249/250), respectively. There was no significant difference between SCPMS and urine (p=0.9996). For paired samples with one STI (n=164) or ≥2 STIs (n=39), concordance was 100% (656/656) and 97.2% (175/180), respectively. There was no association between number of STIs and agreement between sample types (p=0.8606).
This study revealed a high level of agreement between SCPMS and urine for detection of STIs in symptomatic Ugandan men, even in the presence of multiple concurrent STIs. SCPMS may be a suitable alternative to urine, with ease of collection, transporting, and processing of samples.
性传播感染（STIs）是一项全球性的健康挑战。在低收入和中等收入国家（LMICs），检测并非常规开展，而这些国家承担着不成比例的性传播感染负担。自我采集阴茎尿道口拭子（SCPMS）是用于性传播感染检测的尿液替代方法，但来自低收入和中等收入国家的数据有限。
在2019年10月至2020年9月期间，在乌干达坎帕拉的政府卫生机构招募患有尿道分泌物综合征的参与者，他们提供尿液和自我采集阴茎尿道口拭子。使用Aptima检测法对样本进行回顾性分析，检测沙眼衣原体（CT）、淋病奈瑟菌（NG）、生殖支原体（MG）和阴道毛滴虫（TV）。对性传播感染结果不一致的配对自我采集阴茎尿道口拭子和尿液样本，使用实时聚合酶链反应检测法进行分析。
在250名参与者中，自我采集阴茎尿道口拭子和尿液样本检测时，分别有66.8%（n = 167）、22.8%（n = 57）、12.8%（n = 32）和2.4%（n = 6）的人淋病奈瑟菌、沙眼衣原体、生殖支原体和阴道毛滴虫检测呈阳性。使用Aptima检测法，尿液和自我采集阴茎尿道口拭子对所有性传播感染的总体一致性为98.7%（987/1000）。经聚合酶链反应检测法判定后，尿液和自我采集阴茎尿道口拭子对淋病奈瑟菌、沙眼衣原体、生殖支原体和阴道毛滴虫的一致性分别为100%（250/250）、97.6%（244/250）、99.6%（249/250）和99.6%（249/250）。自我采集阴茎尿道口拭子和尿液之间无显著差异（p = 0.9996）。对于患有单一性传播感染（n = 164）或≥2种性传播感染（n = 39）的配对样本而言，一致性分别为100%（656/656）和97.2%（175/180）。性传播感染的数量与样本类型之间的一致性无关联（p = 0.8606）。
本研究表明，在有症状的乌干达男性中，自我采集阴茎尿道口拭子和尿液在检测性传播感染方面具有高度一致性，即使存在多种同时发生的性传播感染。自我采集阴茎尿道口拭子可能是尿液的合适替代方法，其样本采集、运输和处理都很简便。
