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“It was difficult to offer same day results”: evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the GeneXpert platform in Zimbabwe

BACKGROUND: Point-of-care testing for sexually transmitted infections (STIs) may improve diagnosis and treatment of STIs in low- and middle-income counties. We explored the facilitators and barriers to point-of-care testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG) for youth in co...

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Autores principales: Martin, Kevin, Dziva Chikwari, Chido, Mackworth-Young, Constance R. S., Chisenga, Mutsawashe, Bandason, Tsitsi, Dauya, Ethel, Olaru, Ioana D., Francis, Suzanna C., Mavodza, Constancia, Nzombe, Portia, Nyamwanza, Rangarirayi, Hove, Fadzanai, Tshuma, Maureen, Machiha, Anna, Kranzer, Katharina, Ferrand, Rashida A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8830017/
https://www.ncbi.nlm.nih.gov/pubmed/35144602
http://dx.doi.org/10.1186/s12913-022-07557-7
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author Martin, Kevin
Dziva Chikwari, Chido
Mackworth-Young, Constance R. S.
Chisenga, Mutsawashe
Bandason, Tsitsi
Dauya, Ethel
Olaru, Ioana D.
Francis, Suzanna C.
Mavodza, Constancia
Nzombe, Portia
Nyamwanza, Rangarirayi
Hove, Fadzanai
Tshuma, Maureen
Machiha, Anna
Kranzer, Katharina
Ferrand, Rashida A.
author_facet Martin, Kevin
Dziva Chikwari, Chido
Mackworth-Young, Constance R. S.
Chisenga, Mutsawashe
Bandason, Tsitsi
Dauya, Ethel
Olaru, Ioana D.
Francis, Suzanna C.
Mavodza, Constancia
Nzombe, Portia
Nyamwanza, Rangarirayi
Hove, Fadzanai
Tshuma, Maureen
Machiha, Anna
Kranzer, Katharina
Ferrand, Rashida A.
author_sort Martin, Kevin
collection PubMed
description BACKGROUND: Point-of-care testing for sexually transmitted infections (STIs) may improve diagnosis and treatment of STIs in low- and middle-income counties. We explored the facilitators and barriers to point-of-care testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG) for youth in community-based settings in Zimbabwe. METHODS: This study was nested within a cluster randomised trial of community-based delivery of integrated HIV and sexual and reproductive health services for youth aged 16 to 24 years. On-site CT/NG testing on urine samples using the Xpert® CT/NG test was piloted in four intervention clusters, with testing performed by service providers. On-site testing was defined as sample processing on the same day and site as sample collection. Outcomes included proportion of tests processed on-site, time between sample collection and collection of results, and proportion of clients receiving treatment. In-depth interviews were conducted with nine service providers and three staff members providing study co-ordination or laboratory support to explore facilitators and barriers to providing on-site CT/NG testing. RESULTS: Of 847 Xpert tests, 296 (35.0%) were performed on-site. Of these, 61 (20.6%) were positive for CT/NG; one (1.6%) received same day aetiological treatment; 33 (54.1%) presented later for treatment; and 5 (8.2%) were treated as a part of syndromic management. There was no difference in the proportion of clients who were treated whether their sample was processed on or off-site (64% (39/61) vs 60% (66/110); p = 0.61). The median (IQR) number of days between sample collection and collection of positive results was 14 (7–35) and 14 (7–52.5) for samples processed on and off-site, respectively, The interviews revealed four themes related to the provision of on-site testing associated with the i) diagnostic device ii) environment, iii) provider, and iv) clients. Some of the specific barriers identified included insufficient testing capacity, inadequate space, as well as reluctance of clients to wait for their results. CONCLUSIONS: In addition to research to optimise the implementation of point-of-care tests for STIs in resource-limited settings, the development of new platforms to reduce analytic time will be necessary to scale up STI testing and reduce the attrition between testing and treatment. TRIAL REGISTRATION: Registered in clinical trials.gov (NCT03719521). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07557-7.
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spelling pubmed-88300172022-02-11 “It was difficult to offer same day results”: evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the GeneXpert platform in Zimbabwe Martin, Kevin Dziva Chikwari, Chido Mackworth-Young, Constance R. S. Chisenga, Mutsawashe Bandason, Tsitsi Dauya, Ethel Olaru, Ioana D. Francis, Suzanna C. Mavodza, Constancia Nzombe, Portia Nyamwanza, Rangarirayi Hove, Fadzanai Tshuma, Maureen Machiha, Anna Kranzer, Katharina Ferrand, Rashida A. BMC Health Serv Res Research Article BACKGROUND: Point-of-care testing for sexually transmitted infections (STIs) may improve diagnosis and treatment of STIs in low- and middle-income counties. We explored the facilitators and barriers to point-of-care testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG) for youth in community-based settings in Zimbabwe. METHODS: This study was nested within a cluster randomised trial of community-based delivery of integrated HIV and sexual and reproductive health services for youth aged 16 to 24 years. On-site CT/NG testing on urine samples using the Xpert® CT/NG test was piloted in four intervention clusters, with testing performed by service providers. On-site testing was defined as sample processing on the same day and site as sample collection. Outcomes included proportion of tests processed on-site, time between sample collection and collection of results, and proportion of clients receiving treatment. In-depth interviews were conducted with nine service providers and three staff members providing study co-ordination or laboratory support to explore facilitators and barriers to providing on-site CT/NG testing. RESULTS: Of 847 Xpert tests, 296 (35.0%) were performed on-site. Of these, 61 (20.6%) were positive for CT/NG; one (1.6%) received same day aetiological treatment; 33 (54.1%) presented later for treatment; and 5 (8.2%) were treated as a part of syndromic management. There was no difference in the proportion of clients who were treated whether their sample was processed on or off-site (64% (39/61) vs 60% (66/110); p = 0.61). The median (IQR) number of days between sample collection and collection of positive results was 14 (7–35) and 14 (7–52.5) for samples processed on and off-site, respectively, The interviews revealed four themes related to the provision of on-site testing associated with the i) diagnostic device ii) environment, iii) provider, and iv) clients. Some of the specific barriers identified included insufficient testing capacity, inadequate space, as well as reluctance of clients to wait for their results. CONCLUSIONS: In addition to research to optimise the implementation of point-of-care tests for STIs in resource-limited settings, the development of new platforms to reduce analytic time will be necessary to scale up STI testing and reduce the attrition between testing and treatment. TRIAL REGISTRATION: Registered in clinical trials.gov (NCT03719521). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07557-7. BioMed Central 2022-02-10 /pmc/articles/PMC8830017/ /pubmed/35144602 http://dx.doi.org/10.1186/s12913-022-07557-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Martin, Kevin
Dziva Chikwari, Chido
Mackworth-Young, Constance R. S.
Chisenga, Mutsawashe
Bandason, Tsitsi
Dauya, Ethel
Olaru, Ioana D.
Francis, Suzanna C.
Mavodza, Constancia
Nzombe, Portia
Nyamwanza, Rangarirayi
Hove, Fadzanai
Tshuma, Maureen
Machiha, Anna
Kranzer, Katharina
Ferrand, Rashida A.
“It was difficult to offer same day results”: evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the GeneXpert platform in Zimbabwe
title “It was difficult to offer same day results”: evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the GeneXpert platform in Zimbabwe
title_full “It was difficult to offer same day results”: evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the GeneXpert platform in Zimbabwe
title_fullStr “It was difficult to offer same day results”: evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the GeneXpert platform in Zimbabwe
title_full_unstemmed “It was difficult to offer same day results”: evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the GeneXpert platform in Zimbabwe
title_short “It was difficult to offer same day results”: evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the GeneXpert platform in Zimbabwe
title_sort “it was difficult to offer same day results”: evaluation of community-based point-of-care testing for sexually transmitted infections among youth using the genexpert platform in zimbabwe
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8830017/
https://www.ncbi.nlm.nih.gov/pubmed/35144602
http://dx.doi.org/10.1186/s12913-022-07557-7
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