Gigi Ranjana M S, Mdingi Mandisa M, Bütikofer Lukas, Babalola Chibuzor M, Klausner Jeffrey D, Medina-Marino Andrew, Muzny Christina A, Taylor Christopher M, van de Wijgert Janneke H H M, Peters Remco P H, Low Nicola
Research Unit, Foundation for Professional Development, East London, South Africa.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
BMC Health Serv Res. 2025 Apr 4;25(1):501. doi: 10.1186/s12913-025-12607-x.
Same-day testing and treatment of curable sexually transmitted infections (STI) is a strategy to reduce infection duration and onward transmission. South African primary healthcare facilities often lack sufficient waiting spaces. This study aimed to assess the proportion of, and factors influencing, pregnant women waiting for on-site STI test results before and after the installation of clinic-based waiting rooms.
We conducted an observational quality improvement study at 5 public primary healthcare facilities in South Africa from March 2021 to May 2023. The intervention was the installation of a waiting room in two clinics. Three clinics were used as comparators: two already had a waiting room in an existing building and one had access to a shared waiting area. The outcome was the percentage of women who waited for their STI test results. We conducted univariable and multivariable analyses and report marginal risk differences (with 95% confidence intervals, CI) of the proportions of women who waited for results. A subset of women answered structured questions about factors influencing their decision to wait for results.
We analysed data from 624 women across the 5 facilities. Overall, 36% (95% CI 31 to 40) waited for their test results (range 7 to 89%). In the two intervention clinics, 17% (95% CI 11 to 24) waited for results before the introduction of a waiting room and 10% (95% CI 5 to 18) after (crude absolute difference - 7% (95% CI -16 to + 3), adjusted difference, -6% (95% CI -17 to + 5)). The percentages of pregnant women waiting for STI test results were higher throughout the study period in 2 clinics which always had a dedicated waiting room than in 2 clinics where a waiting room was installed, or in 1 clinic, which only had access to a shared waiting area. Most women reported before testing that they did not intend to wait and none of the suggested factors would change their decision.
Introduction of a waiting room did not increase the proportion of women who waited for their results in this observational study. Future studies should investigate infrastructure, individual and test-based factors that affect same-day STI testing and treatment.
对可治愈性传播感染（STI）进行当日检测和治疗是一种减少感染持续时间和后续传播的策略。南非的初级医疗保健设施往往缺乏足够的候诊空间。本研究旨在评估在设立基于诊所的候诊室前后，等待现场STI检测结果的孕妇比例及其影响因素。
2021年3月至2023年5月，我们在南非的5家公立初级医疗保健机构开展了一项观察性质量改进研究。干预措施是在两家诊所设立候诊室。三家诊所作为对照：两家在现有建筑中已有候诊室，一家可使用共享候诊区。观察指标是等待STI检测结果的女性比例。我们进行了单变量和多变量分析，并报告了等待结果的女性比例的边际风险差异（95%置信区间，CI）。一部分女性回答了关于影响她们等待结果决定的因素的结构化问题。
我们分析了5家机构中624名女性的数据。总体而言，36%（95%CI 31至40）的女性等待检测结果（范围为7%至89%）。在两家干预诊所中，设立候诊室前17%（95%CI 11至24）的女性等待结果，设立后为10%（95%CI 5至18）（粗略绝对差异 -7%（95%CI -16至 +3），调整差异 -6%（95%CI -17至 +5））。在整个研究期间，两家一直设有专用候诊室的诊所中等待STI检测结果的孕妇比例高于两家设立了候诊室的诊所，以及一家只能使用共享候诊区的诊所。大多数女性在检测前表示她们不打算等待，且没有任何所提及的因素会改变她们的决定。
在这项观察性研究中，设立候诊室并未增加等待检测结果的女性比例。未来的研究应调查影响当日STI检测和治疗的基础设施、个体及检测相关因素。
