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Charlotte Gaydos: Using Self-Collected Specimens to Improve and Extend Delivery of Chlamydia Screening
1. Using Self-Collected Specimens to Improve and Extend Delivery of Chlamydia Screening: A Roundtable Discussion Charlotte A. Gaydos, MS, DrPH Professor Division of Infectious Diseases Johns Hopkins University National Chlamydia Coalition Washington, DC December 3-4, 2009
8. Relative Comparison of Sensitivity of Various Types of Tests for Detection of Chlamydia or Gonorrhea *Nucleic Acid Amplification Test NAAT* Signal Amplification Test Direct Probe Test Enzyme Immunoassay Sensitivity Range/Sample 1 10 10 2 10 3 10 4 10 5 10 6 10 7 10 8 Number/ organisms per sample
12. 16.0% 5.4% 7.9% 10.4% 4.1% Female U.S. Army Recruits: RESULTS 7.9% Gaydos et al. STD 30:539-544, 2003 Mean Age: 20.6 years. OR 2.8 (proportion <25 yr = 85.8%) 1996: 8.51% 1997: 9.68% 1998: 9.90% 1999: 9.92% p = 0.018, using 1996 as referent
13. South: n = 10,963 (12.3%) Northeast: n = 3,746 (7.5%) Midwest: n = 4,128 (7.3%) West: n = 3,779 (5.8%) Territories: n =391 (9.5.%) Female U.S. Army Recruits: 1996-1999 Chlamydia Prevalence, by urine LCR (n=23,007) CDC Reporting Region: Northeast, South, Midwest, West, Territories 3 individuals missing region assignment.
14. Chlamydia or Gonorrhea (13.6%) ED Mehta SD et al. Sex Transm Dis 2001;28:33 22% >1 sex partner in the past 90 days; 37% male, vol rate 77%; 28% new sex partner in the past 90 days; 76% of infections were undetected by clinicians at initial ED visit
15. Vaginal Swabs Are Appropriate Specimens for Diagnosis of Genital Tract Infection with C. trachomatis Schachter et al. JCM 2003;41:3784-3789 NAAT sensitivity: Vaginal Swabs 93% Cervical Swabs 91% FVU 80.6% Culture Sensitivity 83.5% Specificities All Specimens >99% GenProbe APTIMA COMBO2 now FDA cleared for vaginal swabs
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17. Assessment of ease of use of vaginal swabs Most Women reported that vaginal swabs were “easy” to collect!
31. Female CT Prevalence: Results by Age (N = 1191*) 11.1% Infected 6.8% Infected 15.3% Infected *12 did not report age. There were 9 women 14 yr old, all were chlamydia negative 1.2% Infected
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39. Male Questionnaire Results Home collection (N = 501) Swab 89.8% 94.0% 91.4% Urine 95.3% No swab: 8; No urine 2