المؤلفون: Anthony Nardone, Richard Pebody, Lorenzo Subissi, Isabel Bergeri, Aisling Vaughan, Erika Duffell, Gudrun S Freidl, Diogo Simão Lemos, M Valenciano, Eeva K Broberg, Pasi Penttinen, Maria Keramarou

المصدر: BMJ Open, Vol 13, Iss 11 (2023)

مصطلحات موضوعية: Medicine

الوصف: Objectives Systematic review of SARS-CoV-2 seroprevalence studies undertaken in the WHO European Region to measure pre-existing and cumulative seropositivity prior to the roll out of vaccination programmes.Design A systematic review of the literature.Data sources We searched MEDLINE, EMBASE and the preprint servers MedRxiv and BioRxiv in the WHO ‘COVID-19 Global literature on coronavirus disease’ database using a predefined search strategy. Articles were supplemented with unpublished WHO-supported Unity-aligned seroprevalence studies and other studies reported directly to WHO Regional Office for Europe and European Centre for Disease Prevention and Control.Eligibility criteria Studies published before the widespread implementation of COVID-19 vaccination programmes in January 2021 among the general population and blood donors, at national and regional levels.Data extraction and synthesis At least two independent researchers extracted the eligible studies; a third researcher resolved any disagreements. Study risk of bias was assessed using a quality scoring system based on sample size, sampling and testing methodologies.Results In total, 111 studies from 26 countries published or conducted between 1 January 2020 and 31 December 2020 across the WHO European Region were included. A significant heterogeneity in implementation was noted across the studies, with a paucity of studies from the east of the Region. Sixty-four (58%) studies were assessed to be of medium to high risk of bias. Overall, SARS-CoV-2 seropositivity prior to widespread community circulation was very low. National seroprevalence estimates after circulation started ranged from 0% to 51.3% (median 2.2% (IQR 0.7–5.2%); n=124), while subnational estimates ranged from 0% to 52% (median 5.8% (IQR 2.3%–12%); n=101), with the highest estimates in areas following widespread local transmission.Conclusions The low levels of SARS-CoV-2 antibody in most populations prior to the start of vaccine programmes underlines the critical importance of targeted vaccination of priority groups at risk of severe disease, while maintaining reduced levels of transmission to minimise population morbidity and mortality.

وصف الملف: electronic resource

العلاقة: https://bmjopen.bmj.com/content/13/11/e064240.fullTest; https://doaj.org/toc/2044-6055Test

الوصول الحر: https://doaj.org/article/5f985260661f4f17b05d52cc72c7438eTest

المؤلفون: Lewis, HC, Ware, H, Whelan, M, Subissi, L, Li, Z, Ma, X, Nardone, A, Valenciano, M, Cheng, B, Noel, K, Cao, C, Yanes-Lane, M, Herring, BL, Talisuna, A, Ngoy, N, Balde, T, Clifton, D, Van Kerkhove, MD, Buckeridge, D, Bobrovitz, N, Okeibunor, J, Arora, RK, Bergeri, I

المساهمون: Group, UNITY Studies Collaborator

الوصف: Introduction Estimating COVID-19 cumulative incidence in Africa remains problematic due to challenges in contact tracing, routine surveillance systems and laboratory testing capacities and strategies. We undertook a meta-analysis of population-based seroprevalence studies to estimate SARS-CoV-2 seroprevalence in Africa to inform evidence-based decision making on public health and social measures (PHSM) and vaccine strategy. Methods We searched for seroprevalence studies conducted in Africa published 1 January 2020–30 December 2021 in Medline, Embase, Web of Science and Europe PMC (preprints), grey literature, media releases and early results from WHO Unity studies. All studies were screened, extracted, assessed for risk of bias and evaluated for alignment with the WHO Unity seroprevalence protocol. We conducted descriptive analyses of seroprevalence and meta-analysed seroprevalence differences by demographic groups, place and time. We estimated the extent of undetected infections by comparing seroprevalence and cumulative incidence of confirmed cases reported to WHO.PROSPERO: CRD42020183634. Results We identified 56 full texts or early results, reporting 153 distinct seroprevalence studies in Africa. Of these, 97 (63%) were low/moderate risk of bias studies. SARS-CoV-2 seroprevalence rose from 3.0% (95% CI 1.0% to 9.2%) in April–June 2020 to 65.1% (95% CI 56.3% to 73.0%) in July–September 2021. The ratios of seroprevalence from infection to cumulative incidence of confirmed cases was large (overall: 100:1, ranging from 18:1 to 954:1) and steady over time. Seroprevalence was highly heterogeneous both within countries—urban versus rural (lower seroprevalence for rural geographic areas), children versus adults (children aged 0–9 years had the lowest seroprevalence)—and between countries and African subregions. Conclusion We report high seroprevalence in Africa suggesting greater population exposure to SARS-CoV-2 and potential protection against COVID-19 severe disease than indicated by surveillance data. As ...

العلاقة: https://ora.ox.ac.uk/objects/uuid:846ca54f-f52a-4340-ac71-3ad791046877Test; https://doi.org/10.1136/bmjgh-2022-008793Test

الإتاحة: https://doi.org/10.1136/bmjgh-2022-008793Test
https://ora.ox.ac.uk/objects/uuid:846ca54f-f52a-4340-ac71-3ad791046877Test

المؤلفون: Katherine Esposito, Maria Ida Maiorino, Giuseppe Bellastella, Dario Giugliano, Francesco Saverio Mennini, Marco Trabucco Aurilio, Lorenzo Scappaticcio, Miriam Longo, Claudia Nardone, Luca Coppeta, Simone Gazzillo, Raffaele Migliorini

المصدر: BMJ Open, Vol 12, Iss 5 (2022)

مصطلحات موضوعية: Medicine

وصف الملف: electronic resource

العلاقة: https://bmjopen.bmj.com/content/12/5/e057825.fullTest; https://doaj.org/toc/2044-6055Test

الوصول الحر: https://doaj.org/article/b5cc7e065a8a44f98bb9a1c63895e413Test

المؤلفون: Anthony Nardone, Jesse Papenburg, Marta Valenciano, Hude Quan, Maria D Van Kerkhove, Didier K Ekouevi, Tyler Williamson, Shobna Sawry, Xiaomeng Ma, Ambrose Talisuna, Thierno Balde, Ines Vigan-Womas, David Buckeridge, Halidou Tinto, Michael Liu, Tingting Yan, Matthew P Cheng, Joseph Okeibunor, Samiratou Ouedraogo, Francine Ntoumi, Cheikh Talla, David Clifton, Tiffany G Harris, Ayôla A Adegnika, Lorenzo Subissi, Laura Steinhardt, Niklas Bobrovitz, Isidore T Traore, Timothy G Evans, Judy Chen, Cedric P Yansouni, Cheryl Cohen, Jason M Mwenda, Nsenga Ngoy, Hannah C Lewis, Harriet Ware, Mairead Whelan, Zihan Li, Brianna Cheng, Kim Noel, Christian Cao, Mercedes Yanes-Lane, Belinda L Herring, Rahul K Arora, Isabel Bergeri, Rafiou Adamou, Samira Z Assoumou, Rosemary A Audu, Jacob S Barnor, Enyew Birru, Henry K Bosa, Emily L Boucher, Annie Chauma-Mwale, Tienhan S Dabakuyo-Yonli, Gabriel Deveaux, Boly Diop, Titus H Divala, Emily K Dokubo, Irene O Donkor, Claire Donnici, Nathan Duarte, Natalie A Duarte, Paulin N Essone, Lee Fairlie, Ousmane Faye, Anne von Gottberg, Natasha Ilincic, Elsie A Ilori, Jackie Kleynhans, Dayoung Kim, Olatunji M Kolawole, Jambo C Kondwani, Emma Loeschnik, Sheila Makiala-Mandanda, Alexandre Manirakiza, Pinyi N Mawien, Portia C Mutevedzi, Edgard B Ngoungou, Eric M Osoro, Sandrine L Oyegue, Sara Perlman-Arrow, Hannah P Rahim, Karampreet Sachathep, Mitchell Segal, Anabel Selemon, Judith Shang, Joel F Djoba Siawaya, Kristen A Stafford, Joe A Theu, Caseng Zhang

المصدر: BMJ Global Health, Vol 7, Iss 8 (2022)

مصطلحات موضوعية: Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216

الوصف: Introduction Estimating COVID-19 cumulative incidence in Africa remains problematic due to challenges in contact tracing, routine surveillance systems and laboratory testing capacities and strategies. We undertook a meta-analysis of population-based seroprevalence studies to estimate SARS-CoV-2 seroprevalence in Africa to inform evidence-based decision making on public health and social measures (PHSM) and vaccine strategy.Methods We searched for seroprevalence studies conducted in Africa published 1 January 2020–30 December 2021 in Medline, Embase, Web of Science and Europe PMC (preprints), grey literature, media releases and early results from WHO Unity studies. All studies were screened, extracted, assessed for risk of bias and evaluated for alignment with the WHO Unity seroprevalence protocol. We conducted descriptive analyses of seroprevalence and meta-analysed seroprevalence differences by demographic groups, place and time. We estimated the extent of undetected infections by comparing seroprevalence and cumulative incidence of confirmed cases reported to WHO.PROSPERO: CRD42020183634.Results We identified 56 full texts or early results, reporting 153 distinct seroprevalence studies in Africa. Of these, 97 (63%) were low/moderate risk of bias studies. SARS-CoV-2 seroprevalence rose from 3.0% (95% CI 1.0% to 9.2%) in April–June 2020 to 65.1% (95% CI 56.3% to 73.0%) in July–September 2021. The ratios of seroprevalence from infection to cumulative incidence of confirmed cases was large (overall: 100:1, ranging from 18:1 to 954:1) and steady over time. Seroprevalence was highly heterogeneous both within countries—urban versus rural (lower seroprevalence for rural geographic areas), children versus adults (children aged 0–9 years had the lowest seroprevalence)—and between countries and African subregions.Conclusion We report high seroprevalence in Africa suggesting greater population exposure to SARS-CoV-2 and potential protection against COVID-19 severe disease than indicated by surveillance data. As ...

العلاقة: https://gh.bmj.com/content/7/8/e008793.fullTest; https://doaj.org/toc/2059-7908Test; https://doaj.org/article/e44a4cf7a28b408ca4de2779c44026fbTest

الإتاحة: https://doi.org/10.1136/bmjgh-2022-008793Test
https://doaj.org/article/e44a4cf7a28b408ca4de2779c44026fbTest

المؤلفون: Vitale, Alessandro, Svegliati-Baroni, Gianluca, Ortolani, Alessio, Cucco, Monica, Dalla Riva, Giulio V, Giannini, Edoardo G, Piscaglia, Fabio, Rapaccini, Gianludovico, Di Marco, Mariella, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Cabibbo, Giuseppe, Marra, Fabio, Mega, Andrea, Morisco, Filomena, Gasbarrini, Antonio, Foschi, Francesco Giuseppe, Missale, Gabriele, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Oliveri, Filippo, Pelizzaro, Filippo, Ramirez Morales, Rafael, Cillo, Umberto, Trevisani, Franco, Miele, Luca, Marchesini, Giulio, Farinati, Fabio

المساهمون: Vitale, Alessandro, Svegliati-Baroni, Gianluca, Ortolani, Alessio, Cucco, Monica, Dalla Riva, Giulio V, Giannini, Edoardo G, Piscaglia, Fabio, Rapaccini, Gianludovico, Di Marco, Mariella, Caturelli, Eugenio, Zoli, Marco, Sacco, Rodolfo, Cabibbo, Giuseppe, Marra, Fabio, Mega, Andrea, Morisco, Filomena, Gasbarrini, Antonio, Foschi, Francesco Giuseppe, Missale, Gabriele, Masotto, Alberto, Nardone, Gerardo, Raimondo, Giovanni, Azzaroli, Francesco, Vidili, Gianpaolo, Oliveri, Filippo, Pelizzaro, Filippo, Ramirez Morales, Rafael, Cillo, Umberto, Trevisani, Franco, Miele, Luca, Marchesini, Giulio, Farinati, Fabio

مصطلحات موضوعية: hepatocellular carcinoma, nonalcoholic steatohepatitis

الوصف: Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) represents a new inclusive definition of the whole spectrum of liver diseases associated to metabolic disorders. The main objective of this study was to compare patients with MAFLD and non-MAFLD with hepatocellular carcinoma (HCC) included in a nationally representative cohort. Methods: We analysed 6882 consecutive patients with HCC enrolled from 2002 to 2019 by 23 Italian Liver Cancer centres to compare epidemiological and future trends in three subgroups: pure, single aetiology MAFLD (S-MAFLD); mixed aetiology MAFLD (metabolic and others, M-MAFLD); and non-MAFLD HCC. Results: MAFLD was diagnosed in the majority of patients with HCC (68.4%). The proportion of both total MAFLD and S-MAFLD HCC significantly increased over time (from 50.4% and 3.6% in 2002-2003, to 77.3% and 28.9% in 2018-2019, respectively, p<0.001). In Italy S-MAFLD HCC is expected to overcome M-MAFLD HCC in about 6 years. Patients with S-MAFLD HCC were older, more frequently men and less frequently cirrhotic with clinically relevant portal hypertension and a surveillance-related diagnosis. They had more frequently large tumours and extrahepatic metastases. After weighting, and compared with patients with non-MAFLD, S-MAFLD and M-MAFLD HCC showed a significantly lower overall (p=0.026, p=0.004) and HCC-related (p<0.001, for both) risk of death. Patients with S-MAFLD HCC showed a significantly higher risk of non-HCC-related death (p=0.006). Conclusions: The prevalence of MAFLD HCC in Italy is rapidly increasing to cover the majority of patients with HCC. Despite a less favourable cancer stage at diagnosis, patients with MAFLD HCC have a lower risk of HCC-related death, suggesting reduced cancer aggressiveness.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/34933916; info:eu-repo/semantics/altIdentifier/wos/WOS:000733795700001; volume:72; issue:1; firstpage:141; lastpage:152; numberofpages:12; journal:GUT; https://hdl.handle.net/11577/3466706Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85145425936

الإتاحة: https://doi.org/10.1136/gutjnl-2021-324915Test
https://hdl.handle.net/11577/3466706Test

المؤلفون: Curtis, T, Rodger, AJ, Burns, F, Nardone, A, Copas, A, Wayal, S

المصدر: Sexually Transmitted Infections , 96 (3) pp. 197-203. (2020)

مصطلحات موضوعية: sexual behaviour, gay men, sexual health, HIV testing, substance misuse

الوصف: Objective: London has one of the highest identified prevalence of chemsex (sexualised recreational drug use) among men who have sex with men (MSM) in Europe. We examine MSM’s patterns of chemsex and its association with HIV/STI risk behaviours, STI diagnoses, and sexual healthcare-seeking behaviours, including if HIV testing behaviour met UK national guidelines (3-monthly if engaging in chemsex). Methods: Cross-sectional survey data from 2013 (n=905) and 2016 (n=739) were collected using anonymous, self-administered questionnaires from MSM recruited in commercial gay venues in London, UK. Descriptive and multivariable analyses, stratified by self-reported HIV status, were conducted. Adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) were calculated. Results: Comparing the 2013 and 2016 surveys; chemsex prevalence in the past year remained stable, in both HIV-negative/unknown-status MSM (20.9% in 2013 vs 18.7% in 2016, p=0.301) and HIV-positive MSM (41.6% in 2013 vs 41.7% in 2016, p=0.992). Combined 2013-2016 data showed that compared to other MSM, those reporting chemsex were more likely to report HIV/STI risk behaviours, including condomless anal intercourse with serodifferent HIV-status partners (HIV-negative/unknown-status men: aPR 2.36, 95% CI 1.68-3.30; HIV-positive men: aPR 4.19, 95% CI 1.85-9.50), and STI diagnoses in the past year (HIV-negative/unknown-status men: aPR 2.10, 95% CI 1.64-2.69; HIV-positive men: aPR 2.56, 95% CI 1.57-4.20). 69.0% of HIV-negative/unknown-status men reporting chemsex attended sexual health clinics and 47.6% had tested for HIV more than once in the past year. Conclusions: Chemsex in London MSM remained stable but high, particularly among HIV-positive men. Irrespective of HIV status, chemsex was associated with engagement in HIV/STI risk behaviours. Frequency of HIV testing in the past year among HIV-negative/unknown-status men was below national recommendations. Promoting combination prevention strategies, including 3-monthly HIV/STI testing, access to ...

وصف الملف: text

العلاقة: https://discovery.ucl.ac.uk/id/eprint/10084595/3/Curtis_Patterns%20of%20sexualised%20recreational%20drug%20use%20and%20its%20association%20with%20risk%20behaviours%20and%20sexual%20health%20outcomes%20in%20men%20who%20have%20sex%20with%20men%20in%20London,%20UK_AAM.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10084595Test/

الإتاحة: https://discovery.ucl.ac.uk/id/eprint/10084595/3/Curtis_Patterns%20of%20sexualised%20recreational%20drug%20use%20and%20its%20association%20with%20risk%20behaviours%20and%20sexual%20health%20outcomes%20in%20men%20who%20have%20sex%20with%20men%20in%20London,%20UK_AAM.pdfTest
https://discovery.ucl.ac.uk/id/eprint/10084595Test/

المؤلفون: Smolarchuk, Christa, Mohammed, Hamish, Furegato, Martina, Town, Katy, Fifer, Helen, Wilson, Janet, Nardone, Anthony, Lee, Andrew, Hughes, Gwenda

الوصف: OBJECTIVES: To determine if media coverage of an outbreak of high-level azithromycin-resistant Neisseria gonorrhoeae (HL-AziR) impacted online search interest or was temporally associated with health-seeking behaviours in several English cities. METHODS: A descriptive analysis of outbreak-related online media articles and relative search interest (RSI) using Google and an interrupted time series analysis using routine surveillance data from sexual health clinics (SHCs) in England (GUMCAD STI surveillance system). The main outcomes were adjusted incidence rate ratios (IRRs) of weekly attendances, gonorrhoea tests and diagnoses of gonorrhoea or 'any STI' in selected cities after media coverage of the outbreak in 2015 and 2016. RESULTS: RSI for outbreak-related terms peaked during media coverage in September 2015 with smaller peaks coinciding with subsequent coverage. The greatest increase in RSI was in Leeds, which coincided with a 63% rise (n=1932; IRR 1.26, 95% CI 1.12 to 1.43) in SHC attendances by women. There was only a 7% (n=1358; IRR 1.01, 95% CI 0.91 to 1.11) increase in attendances by men. Modest increases in outcomes occurred in four other cities with a high RSI. There was no evidence of increases in outcomes in cities, other than Leeds, after subsequent media coverage of the outbreak. CONCLUSIONS: National and local media coverage of the HL-AziR outbreak coincided with peak RSI for related terms, and a transient increase in attendances, gonorrhoea tests and diagnoses of gonorrhoea or 'any STI' in some cities with a high RSI. Our analysis demonstrates the potential for media coverage to influence health-seeking behaviours during high-profile STI outbreaks.

وصف الملف: text

العلاقة: https://researchonline.lshtm.ac.uk/id/eprint/4663826/7/Smolarchuk_etal_2019_Just-google-it-impact-of.pdfTest; Smolarchuk, Christa; Mohammed, Hamish; Furegato, Martina; Town, Katy; Fifer, Helen; Wilson, Janet; Nardone, Anthony; Lee, Andrew; Hughes, Gwenda ; (2019) Just Google it! Impact of media coverage of an outbreak of high-level azithromycin-resistant Neisseria gonorrhoeae on online searches, and attendances, testing and diagnoses at sexual health clinics in England between 2015 and 2016: an interrupted time series analysis using surveillance data. Sexually transmitted infections, 95 (8). pp. 594-601. ISSN 1368-4973 DOI: https://doi.org/10.1136/sextrans-2019-053986Test

الإتاحة: https://doi.org/10.1136/sextrans-2019-053986Test
https://researchonline.lshtm.ac.uk/id/eprint/4663826Test/
https://researchonline.lshtm.ac.uk/id/eprint/4663826/7/Smolarchuk_etal_2019_Just-google-it-impact-of.pdfTest

المؤلفون: Mohammed, Hamish, Blomquist, Paula, Ogaz, Dana, Duffell, Stephen, Furegato, Martina, Checchi, Marta, Irvine, Neil, Wallace, Lesley A, Thomas, Daniel Rhys, Nardone, Anthony, Dunbar, J Kevin, Hughes, Gwenda

الوصف: OBJECTIVES: The 1916 Royal Commission on Venereal Diseases was established in response to epidemics of syphilis and gonorrhoea in the UK. In the 100 years since the Venereal Diseases Act (1917), the UK has experienced substantial scientific, economic and demographic changes. We describe historical and recent trends in STIs in the UK. METHODS: We analysed surveillance data derived from STI clinics' statistical returns from 1917 to 2016. RESULTS: Since 1918, gonorrhoea and syphilis diagnoses have fluctuated, reflecting social, economic and technological trends. Following spikes after World Wars I and II, rates declined before re-emerging during the 1960s. At that time, syphilis was more common in men, suggestive of transmission within the men who have sex with men (MSM) population. Behaviour change following the emergence of HIV/AIDS in the 1980s is thought to have facilitated a precipitous decline in diagnoses of both STIs in the mid-1980s. Since the early 2000s, gonorrhoea and syphilis have re-emerged as major public health concerns due to increased transmission among MSM and the spread of antimicrobial-resistant gonorrhoea. Chlamydia and genital warts are now the most commonly diagnosed STIs in the UK and have been the focus of public health interventions, including the national human papillomavirus vaccination programme, which has led to substantial declines in genital warts in young people, and the National Chlamydia Screening Programme in England. Since the 1980s, MSM, black ethnic minorities and young people have experienced the highest STI rates. CONCLUSION: Although diagnoses have fluctuated over the last century, STIs continue to be an important public health concern, often affecting more marginalised groups in society. Prevention must remain a public health priority and, as we enter a new era of sexual healthcare provision including online services, priority must be placed on maintaining prompt access for those at greatest risk of STIs.

وصف الملف: text

العلاقة: https://researchonline.lshtm.ac.uk/id/eprint/4663846/7/Mohammed_etal_2018_100-years-of-stis-in.pdfTest; Mohammed, Hamish; Blomquist, Paula; Ogaz, Dana; Duffell, Stephen; Furegato, Martina; Checchi, Marta; Irvine, Neil; Wallace, Lesley A; Thomas, Daniel Rhys; Nardone, Anthony; +2 more. Dunbar, J Kevin; Hughes, Gwenda ; (2018) 100 years of STIs in the UK: a review of national surveillance data. Sexually transmitted infections, 94 (8). pp. 553-558. ISSN 1368-4973 DOI: https://doi.org/10.1136/sextrans-2017-053273Test

الإتاحة: https://doi.org/10.1136/sextrans-2017-053273Test
https://researchonline.lshtm.ac.uk/id/eprint/4663846Test/
https://researchonline.lshtm.ac.uk/id/eprint/4663846/7/Mohammed_etal_2018_100-years-of-stis-in.pdfTest

المؤلفون: Harding-Esch, EM, Nori, AV, Hegazi, A, Pond, MJ, Okolo, O, Nardone, A, Lowndes, CM, Hay, P, Sadiq, ST

الوصف: OBJECTIVES: To assess clinical service value of STI point-of-care test (POCT) use in a 'sample first' clinical pathway (patients providing samples on arrival at clinic, before clinician consultation). Specific outcomes were: patient acceptability; whether a rapid nucleic acid amplification test (NAAT) for Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG) could be used as a POCT in practice; feasibility of non-NAAT POCT implementation for Trichomonas vaginalis (TV) and bacterial vaginosis (BV); impact on patient diagnosis and treatment. METHODS: Service evaluation in a south London sexual health clinic. Symptomatic female and male patients and sexual contacts of CT/NG-positive individuals provided samples for diagnostic testing on clinic arrival, prior to clinical consultation. Tests included routine culture and microscopy; CT/NG (GeneXpert) NAAT; non-NAAT POCTs for TV and BV. RESULTS: All 70 (35 males, 35 females) patients approached participated. The 'sample first' pathway was acceptable, with >90% reporting they were happy to give samples on arrival and receive results in the same visit. Non-NAAT POCT results were available for all patients prior to leaving clinic; rapid CT/NG results were available for only 21.4% (15/70; 5 males, 10 females) of patients prior to leaving clinic. Known negative CT/NG results led to two females avoiding presumptive treatment, and one male receiving treatment directed at possible Mycoplasma genitalium infection causing non-gonococcal urethritis. Non-NAAT POCTs detected more positives than routine microscopy (TV 3 vs 2; BV 24 vs 7), resulting in more patients receiving treatment. CONCLUSIONS: A 'sample first' clinical pathway to enable multiple POCT use was acceptable to patients and feasible in a busy sexual health clinic, but rapid CT/NG processing time was too long to enable POCT use. There is need for further development to improve test processing times to enable POC use of rapid NAATs.

وصف الملف: application/pdf

العلاقة: https://openaccess.sgul.ac.uk/id/eprint/108628/1/Sex%20Transm%20Infect-2017-Harding-Esch-sextrans-2016-052988.pdfTest; Harding-Esch, EM; Nori, AV; Hegazi, A; Pond, MJ; Okolo, O; Nardone, A; Lowndes, CM; Hay, P; Sadiq, ST (2017) Impact of deploying multiple point-of-care tests with a 'sample first' approach on a sexual health clinical care pathway. A service evaluation. Sex Transm Infect, 93 (6). pp. 424-429. ISSN 1472-3263 https://doi.org/10.1136/sextrans-2016-052988Test SGUL Authors: Harding-Esch, Emma Michele

الإتاحة: https://doi.org/10.1136/sextrans-2016-052988Test
https://openaccess.sgul.ac.uk/id/eprint/108628Test/
https://openaccess.sgul.ac.uk/id/eprint/108628/1/Sex%20Transm%20Infect-2017-Harding-Esch-sextrans-2016-052988.pdfTest

المؤلفون: Mitchell, Holly, Furegato, Martina, Hughes, Gwenda, Field, Nigel, Nardone, Anthony

الوصف: OBJECTIVES: To explore the risk factors for, and clinical outcomes in men who have sex with men (MSM) prescribed HIV postexposure prophylaxis following sexual exposure (PEPSE) at sexual health clinics (SHCs) in England. METHODS: National STI surveillance data were extracted from the genitourinary medicine clinic activity dataset (GUMCADv2) for 2011-2014. Quarterly and annual trends in the number of episodes where PEPSE was prescribed were analysed by gender and sexual risk. Risk factors associated with being prescribed PEPSE among MSM attendees were explored using univariable and multivariable logistic regression. Subsequent HIV acquisition from 4 months after initiating PEPSE was assessed using multivariable Cox proportional hazards models, stratified by clinical risk profiles. RESULTS: During 2011-2014, there were 24 004 episodes where PEPSE was prescribed at SHCs, of which 69% were to MSM. The number of episodes where PEPSE was prescribed to MSM increased from 2383 in 2011 to 5944 in 2014, and from 1384 to 2226 for heterosexual men and women. 15% of MSM attendees received two or more courses of PEPSE. Compared with MSM attendees not prescribed PEPSE, MSM prescribed PEPSE were significantly more likely to have been diagnosed with a bacterial STI in the previous 12 months (adjusted OR (95% CI)-gonorrhoea: 11.6 (10.5 to 12.8); chlamydia: 5.02 (4.46 to 5.67); syphilis: 2.25 (1.73 to 2.93)), and were more likely to subsequently acquire HIV (adjusted HR (aHR) (95% CI)-single PEPSE course: 2.54 (2.19 to 2.96); two or more PEPSE courses: aHR (95% CI) 4.80 (3.69 to 6.25)). The probability of HIV diagnosis was highest in MSM prescribed PEPSE who had also been diagnosed with a bacterial STI in the previous 12 months (aHR (95% CI): 6.61 (5.19 to 8.42)). CONCLUSIONS: MSM prescribed PEPSE are at high risk of subsequent HIV acquisition and our data show further risk stratification by clinical and PEPSE prescribing history is possible, which might inform clinical practice and HIV prevention initiatives in MSM.

وصف الملف: text

العلاقة: https://researchonline.lshtm.ac.uk/id/eprint/4663868/7/Mitchell_etal_2016_What-are-the-characteristics-of.pdfTest; Mitchell, Holly; Furegato, Martina; Hughes, Gwenda ; Field, Nigel; Nardone, Anthony; (2017) What are the characteristics of, and clinical outcomes in men who have sex with men prescribed HIV postexposure prophylaxis following sexual exposure (PEPSE) at sexual health clinics in England? Sexually transmitted infections, 93 (3). pp. 207-213. ISSN 1368-4973 DOI: https://doi.org/10.1136/sextrans-2016-052806Test

الإتاحة: https://researchonline.lshtm.ac.uk/id/eprint/4663868Test/
https://researchonline.lshtm.ac.uk/id/eprint/4663868/7/Mitchell_etal_2016_What-are-the-characteristics-of.pdfTest