Testing for extragenital Neisseria gonorrhoeae and Chlamydia trachomatis: At-home pharyngeal and rectal self-swabs are non-inferior to those completed in healthcare settings.

Bibliographic Details
Title: Testing for extragenital Neisseria gonorrhoeae and Chlamydia trachomatis: At-home pharyngeal and rectal self-swabs are non-inferior to those completed in healthcare settings.
Authors: Lauren Orser, Vanessa Tran, Patrick O'Byrne, Abigail Kroch, Melissa Bonnetsmueller, Maan Hasso, Alexandra Musten
Source: PLoS ONE, Vol 19, Iss 5, p e0302785 (2024)
Publisher Information: Public Library of Science (PLoS), 2024.
Publication Year: 2024
Collection: LCC:Medicine
LCC:Science
Subject Terms: Medicine, Science
More Details: IntroductionThe rates of gonorrhea and chlamydia have been increasing in the years preceding the COVID19 pandemic. Because most gonorrhea and chlamydia infections are located in the oropharynx and rectum for men who have sex with men (MSM), and because at-home self-collected swabs for these infections are not licensed by Health Canada or the United States Food and Drug Administration, decreased accessed to in-person care during and since the COVID19 pandemic potentially means missed case findings.ObjectivesTo evaluate the performance of at-home self-collected pharyngeal and rectal swabs for gonorrhea and chlamydia nucleic acid amplification testing.MethodologyAll persons who contacted our Sexual Health Clinic and who had a clinical indication to complete oral and/or rectal swabs for gonorrhea and chlamydia were invited to complete at-home swabs in advance of their scheduled appointments. We mailed swabs and instructions to those who consented. Participants brought these swabs to their scheduled in clinic appointments, where we repeated the same swabs. All matching swabs were sent to the laboratory for analysis to determine concordance.ResultsFrom September 8, 2022 to July 18, 2023, we enrolled 296 eligible participants who provided 1184 swabs. For analysis, cancelled specimens and specimens with invalid results were excluded, leaving 1032 swabs for comparison. We identified 66 STI diagnoses in 47 unique participants. Overall accuracy was high (exceeding 99%), except for rectal chlamydia, which was 96.0%. While the performance of self-swabs for chlamydia was lower compared to gonorrhea, at-home swabs identified six chlamydia infections that were missed by in-clinic collected swabs (two pharyngeal, four rectal). Removing these six cases as "false positives" increased overall accuracy for chlamydia detection to 99.7% (pharyngeal) and 97.8% (rectal).ConclusionSelf-collected at-home swabs had good performance acceptable for gonorrhea and chlamydia nucleic acid amplification testing.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1932-6203
Relation: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0302785&type=printable; https://doaj.org/toc/1932-6203
DOI: 10.1371/journal.pone.0302785&type=printable
DOI: 10.1371/journal.pone.0302785
Access URL: https://doaj.org/article/2942acb8a31944a8873a221a65600e26
Accession Number: edsdoj.2942acb8a31944a8873a221a65600e26
Database: Directory of Open Access Journals
Full text is not displayed to guests.
More Details
ISSN:19326203
DOI:10.1371/journal.pone.0302785&type=printable
Published in:PLoS ONE
Language:English