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Screening for gonorrhoea using samples collected through the English national chlamydia screening programme and risk of false positives: a national survey of local authorities.

Field N, Kennedy I, Folkard K, Duffell S, Town K, Ison CA, Hughes G - BMJ Open (2014)

Bottom Line: Under reasonable assumptions, the positive predictive value of the screening test is 17-67%.Over half of English LAs already commission dual tests for samples collected by the NCSP.We question the public health benefit here, and suggest that robust testing algorithms and clinical management pathways, together with rigorous evaluation, be implemented wherever dual tests are deployed.

View Article: PubMed Central - PubMed

Affiliation: Research Department of Infection and Population Health, University College London, London, UK Public Health England, National Centre for Infectious Disease Surveillance and Control (CIDSC), London, UK.

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Related in: MedlinePlus

Mean gonorrhoea (NG) diagnoses per 100 000 population (made in GUM clinics) between 2009–2012 by whether LAs use dual tests on samples collected by the National Chlamydia Screening Programme (1) Each vertical dash represents an LA, giving the four year average (2009–2012) for gonorrhoea diagnoses (per 100 000 population) for the 98 LAs responding to the survey, including diagnoses made in GUM clinics collected through GUMCAD (2) Boxes shows the median and lower and upper quartiles for four year average gonorrhoea diagnoses in each group. NG, Neisseria gonorrhoeae; GUM, genitourinary medicine; GUMCAD, GUM Clinic Activity Dataset; LA, Local Authority; NAAT, nucleic acid amplification test.
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BMJOPEN2014006067F1: Mean gonorrhoea (NG) diagnoses per 100 000 population (made in GUM clinics) between 2009–2012 by whether LAs use dual tests on samples collected by the National Chlamydia Screening Programme (1) Each vertical dash represents an LA, giving the four year average (2009–2012) for gonorrhoea diagnoses (per 100 000 population) for the 98 LAs responding to the survey, including diagnoses made in GUM clinics collected through GUMCAD (2) Boxes shows the median and lower and upper quartiles for four year average gonorrhoea diagnoses in each group. NG, Neisseria gonorrhoeae; GUM, genitourinary medicine; GUMCAD, GUM Clinic Activity Dataset; LA, Local Authority; NAAT, nucleic acid amplification test.

Mentions: At an area level, there was no significant difference in Index of Multiple Deprivation, chlamydia positivity among those testing and aged 15–24 years, chlamydia diagnosis rate, or mean chlamydia testing coverage among those aged 15–24 years, when comparing LAs using and not using dual tests (table 2). Mean gonorrhoea diagnosis rates based on diagnoses made in GUM clinics were higher (53 vs 32/100 000; p=0.03) in LAs using dual tests compared with those not using. Nevertheless, most LAs had low gonorrhoea diagnosis rates that were below 50/100 000 (figure 1). We noted three LAs where dual tests were not being used, all in London, where GUM gonorrhoea diagnosis rates were above 100/100 000, placing these areas inside the top 10% nationally.


Screening for gonorrhoea using samples collected through the English national chlamydia screening programme and risk of false positives: a national survey of local authorities.

Field N, Kennedy I, Folkard K, Duffell S, Town K, Ison CA, Hughes G - BMJ Open (2014)

Mean gonorrhoea (NG) diagnoses per 100 000 population (made in GUM clinics) between 2009–2012 by whether LAs use dual tests on samples collected by the National Chlamydia Screening Programme (1) Each vertical dash represents an LA, giving the four year average (2009–2012) for gonorrhoea diagnoses (per 100 000 population) for the 98 LAs responding to the survey, including diagnoses made in GUM clinics collected through GUMCAD (2) Boxes shows the median and lower and upper quartiles for four year average gonorrhoea diagnoses in each group. NG, Neisseria gonorrhoeae; GUM, genitourinary medicine; GUMCAD, GUM Clinic Activity Dataset; LA, Local Authority; NAAT, nucleic acid amplification test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4201998&req=5

BMJOPEN2014006067F1: Mean gonorrhoea (NG) diagnoses per 100 000 population (made in GUM clinics) between 2009–2012 by whether LAs use dual tests on samples collected by the National Chlamydia Screening Programme (1) Each vertical dash represents an LA, giving the four year average (2009–2012) for gonorrhoea diagnoses (per 100 000 population) for the 98 LAs responding to the survey, including diagnoses made in GUM clinics collected through GUMCAD (2) Boxes shows the median and lower and upper quartiles for four year average gonorrhoea diagnoses in each group. NG, Neisseria gonorrhoeae; GUM, genitourinary medicine; GUMCAD, GUM Clinic Activity Dataset; LA, Local Authority; NAAT, nucleic acid amplification test.
Mentions: At an area level, there was no significant difference in Index of Multiple Deprivation, chlamydia positivity among those testing and aged 15–24 years, chlamydia diagnosis rate, or mean chlamydia testing coverage among those aged 15–24 years, when comparing LAs using and not using dual tests (table 2). Mean gonorrhoea diagnosis rates based on diagnoses made in GUM clinics were higher (53 vs 32/100 000; p=0.03) in LAs using dual tests compared with those not using. Nevertheless, most LAs had low gonorrhoea diagnosis rates that were below 50/100 000 (figure 1). We noted three LAs where dual tests were not being used, all in London, where GUM gonorrhoea diagnosis rates were above 100/100 000, placing these areas inside the top 10% nationally.

Bottom Line: Under reasonable assumptions, the positive predictive value of the screening test is 17-67%.Over half of English LAs already commission dual tests for samples collected by the NCSP.We question the public health benefit here, and suggest that robust testing algorithms and clinical management pathways, together with rigorous evaluation, be implemented wherever dual tests are deployed.

View Article: PubMed Central - PubMed

Affiliation: Research Department of Infection and Population Health, University College London, London, UK Public Health England, National Centre for Infectious Disease Surveillance and Control (CIDSC), London, UK.

Show MeSH
Related in: MedlinePlus