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Open Access Point-of-care diagnostics for sexually transmitted infections among migrants in Greece

This article is Open Access under the terms of the Creative Commons CC BY licence.

SETTING

Sexually transmitted infections (STIs) can impact individuals of any demographic. The most common pathogens causing STIs are Chlamydia trachomatis, Neisseria gonorrhea and Trichomonas vaginalis; these can be treated with specific antibiotics.
OBJECTIVE

To compare the GeneXpert CT/NG test-and-treat algorithm to the syndromic approach algorithm and their impact on antibiotic prescription for gonorrhoea and chlamydia STIs.
DESIGN

A retrospective observational study on women aged ≥18 years who accessed the Médecins Sans Frontières Day Care Centre in Athens with complaints related to urogenital infections between January 2021 and March 2022. Women with abnormal vaginal discharge, excluding clinically diagnosed candidiasis, were eligible for Xpert CT/NG testing.
RESULTS

Of the 450 women who accessed care, 84 were eligible for Xpert CT/NG testing, and only one was positive for chlamydia, therefore resulting in saving 81 doses of ceftriaxone and azithromycin, and 19 doses of metronidazole. The cost of Xpert CT/NG testing, including treatment was €4,606.37, while full antibiotic treatment would have costed €536.76.
CONCLUSION

The overall cost of the Xpert CT/NG test-and-treat algorithm was higher than the syndromic approach. However, quality of care should be weighed against the potential benefits of testing and syndromic treatment to determine the best option for each patient; we therefore advocate for decreasing the costs.

Keywords: Chlamydia trachomatis; GeneXpert CT/NG test; Neisseria gonorrhoeae; SORT IT; Structured Operational Research and Training Initiative; antimicrobial resistance

Document Type: Research Article

Affiliations: 1: Médecins Sans Frontières (MSF), Operational Centre Geneva, Mission Greece, Athens, Disaster Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece 2: MSF, Luxembourg Operational Research (LuxOR) Unit, Operational Centre Brussels, Brussels, MSF, Middle East Medical Unit (MEMU), Operational Centre Brussels, Belgium 3: MSF, Luxembourg Operational Research (LuxOR) Unit, Operational Centre Brussels, Brussels 4: MSF, Operational Centre Geneva Medical Department, Geneva, Switzerland; 5: MSF, Operational Centre Geneva Medical Department, Geneva, Switzerland;, Infectious Diseases Unit, Saint Pierre University Hospital, Brussels, Belgium 6: Disaster Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Publication date: March 1, 2024

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