Home-based chlamydia and gonorrhoea screening: a systematic review of strategies and outcomesReport as inadecuate

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BMC Public Health

, 13:189

Environmental health


BackgroundIn many countries, low Chlamydia trachomatis CT and Neisseria gonorrhoeae NG screening rates among young people in primary-care have encouraged screening programs outside of clinics. Nucleic acid amplification tests NAATs make it possible to screen people in homes with self-collected specimens. We systematically reviewed the strategies and outcomes of home-based CT-NG screening programs.

MethodsElectronic databases were searched for home-based CT and-or NG screening studies published since January 2005. Screening information e.g. target group, recruitment and specimen-collection method and quantitative outcomes e.g. number of participants, tests and positivity were extracted. The screening programs were classified into seven groups on the basis of strategies used.

ResultsWe found 29 eligible papers describing 32 home-based screening programs. In seven outreach programs, people were approached in their homes: a median of 97% participants provided specimens and 76% were tested overall 13717 tests. In seven programs, people were invited to receive postal test-kits PTKs at their homes: a median of 37% accepted PTKs, 79% returned specimens and 19% were tested 46225 tests. PTKs were sent along with invitation letters in five programs: a median of 33% returned specimens and 29% of those invited were tested 15126 tests. PTKs were requested through the internet or phone without invitations in four programs and a median of 32% returned specimens 2666 tests. Four programs involved study personnel directly inviting people to receive PTKs: a median of 46% accepted PTKs, 21% returned specimens and 9.1% were tested 341 tests. PTKs were picked-up from designated locations in three programs: a total of 6765 kits were picked-up and 1167 17% specimens were returned for screening. Two programs used a combination of above strategies 2395 tests but the outcomes were not reported separately. The overall median CT positivity was 3.6% inter-quartile range: 1.7-7.3%.

ConclusionsA variety of strategies have been used in home-based CT-NG screening programs. The screening strategies and their feasibility in the local context need to be carefully considered to maximize the effectiveness of home-based screening programs.

KeywordsSexually transmitted infections Chlamydia trachomatis Screening Home AbbreviationsCTChlamydia trachomatis

NGNeisseria gonorrhoeae

NAATNucleic acid amplification test

PTKPostal test kit

STISexually transmissible infection

USUnited States

UKUnited Kingdom

RCTRandomized controlled trial

CIConfidence interval

IQRInter-quartile range

MandCPMen and Chlamydia Project.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-13-189 contains supplementary material, which is available to authorized users.

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Author: Muhammad S Jamil - Jane S Hocking - Heidi M Bauer - Hammad Ali - Handan Wand - Kirsty Smith - Jennifer Walker - Basil D

Source: https://link.springer.com/

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