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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Acceptability, feasibility and cost of point of care testing for sexually transmitted infections among South African adolescents where syndromic management is standard of care
BMC Health Services Research, Volume 23, No. 1, Article 1078, Year 2023
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Description
Background: Young people (YP) in southern Africa are at substantial risk of HIV and sexually transmitted infections (STIs). Despite the epidemiological and biological link between STIs and HIV transmission and acquisition, infections such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) remain widely undiagnosed. Syndromic STI management is the standard of care in low- and middle-income countries (LMICs) despite a high prevalence of asymptomatic infections. We conducted an observational study to explore the acceptability, feasibility, and cost of a STI test-and-treat service for YP in Cape Town. Methods: YP attending a mobile clinic (MC) and a youth centre clinic (YC) were offered STI screening. Urine testing for CT and NG using a 90-min molecular point-of-care (POC) test on the GeneXpert platform was conducted and treatment provided. Data were collated on demographics, sexual behaviour, presence of symptoms, uptake of same-day treatment, prevalence of CT/NG, and service acceptability. Results: Three hundred sixty six participants were enrolled (median age 20, 83% female).57% (209/366) of participants tested positive for either CT (126/366, 34%) or NG (57/366, 16%) or co-infection (26/366, 7%). Clinical symptoms were a poor predictor of GeneXpert diagnosed CT or NG, with a sensitivity of 46.8% and 54.0% for CT and NG respectively. Although half of participants initially chose to receive same day results and treatment, only a third waited for results on the day. The majority of participants (91%) rated the service highly via a post-visit acceptability questionnaire. Conclusion: Curable STIs are highly prevalent in this population. STI screening using POC testing was feasible and acceptability was high. The study provides further impetus for moving policy beyond syndromic management of STIs in South Africa. © 2023, BioMed Central Ltd., part of Springer Nature.
Authors & Co-Authors
Marcus, Rebecca
South Africa, Cape Town
Desmond Tutu Health Foundation
United Kingdom, London
North Middlesex University Hospital
Gill, Katherine
South Africa, Cape Town
Desmond Tutu Health Foundation
Smith, Philip John
South Africa, Cape Town
Desmond Tutu Health Foundation
Mendelsohn, Andrea S.
South Africa, Cape Town
Desmond Tutu Health Foundation
Mendel, Eve
South Africa, Cape Town
Desmond Tutu Health Foundation
Lince-Deroche, Naomi
South Africa, Johannesburg
University of the Witwatersrand
Naidoo, Keshani
South Africa, Cape Town
Desmond Tutu Health Foundation
Ahmed, Nadia
South Africa, Cape Town
Desmond Tutu Health Foundation
United Kingdom, London
University College London
Stirrup, Oliver T.
United Kingdom, London
University College London
Roseleur, Jacqueline
South Africa, Johannesburg
University of the Witwatersrand
Leuner, Rahma
South Africa, Johannesburg
University of the Witwatersrand
Meyer-Rath, Gesine
South Africa, Johannesburg
University of the Witwatersrand
United States, Boston
Boston University
Bekker, Linda Gail
South Africa, Cape Town
Desmond Tutu Health Foundation
Statistics
Authors: 13
Affiliations: 5
Identifiers
Doi:
10.1186/s12913-023-10068-8
ISSN:
14726963
Research Areas
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Study Locations
South Africa
Participants Gender
Female