There are disparately low testing rates for STIs in certain high-risk groups in northern New Zealand.

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dGroup A streptococcal (GAS) pharyngitis is a particularly important condition in areas of New Zealand where the incidence of acute rheumatic fever remains unacceptably high. Prompt diagnosis and treatment of GAS pharyngitis are cornerstones of the Rheumatic Fever Prevention Programme, but these are hindered by the turnaround time of culture. Tests with excellent performance and rapid turnaround times are needed. For this study, throat swabs (Copan ESwabs) were collected from schoolchildren self-identifying with a sore throat. Samples were tested by routine culture and the illumigene GAS assay using loop-mediated isothermal amplification. Discrepant results were resolved by retesting of the same specimen by an alternative molecular assay. Seven hundred fifty-seven throat swab specimens were tested by both methods. The performance characteristics of the illumigene assay using culture on blood agar as the "gold standard" and following discrepancy analysis were as follows: sensitivity, 82% and 87%, respectively; specificity, 93% and 98%, respectively; positive predictive value, 61% and 88%, respectively; and negative predictive value, 97% and 97%, respectively. In our unique setting of a school-based throat swabbing program, the illumigene assay did not perform quite as well as described in previous reports. Despite this, its improved sensitivity and rapid turnaround time compared with those of culture are appealing. Group A streptococcal (GAS) throat infections are particularly significant, as a subgroup of people (typically children) develop acute rheumatic fever (ARF) or acute poststreptococcal glomerulonephritis as a result of such infections. Although treatment of GAS pharyngitis with appropriate antibiotics markedly reduces the risk of ARF, New Zealand continues to have high rates of ARF compared with those in other developed nations (1). In 2011, the New Zealand government announced a target for a reduction in the national incidence of ARF by two-thirds, from 4.2 per 100,000 people in 2011 to 1.4 per 100,000 people by 2017 (2). To achieve this goal, the Rheumatic Fever Prevention Program (RFPP) was initiated with an emphasis on the timely detection and treatment of GAS pharyngitis. The program focuses on improved access to throat swabbing services for school-aged children who are considered to be at the highest risk of ARF, specifically, Ma ori and Pacific children residing in areas of high socioeconomic deprivation (3). A large component of the intervention has been the school-based throat swabbing clinics for children who self-present with sore throats during the school day. As the signs and symptoms of bacterial and viral pharyngitis overlap and differentiation on clinical grounds is difficult, the collection of a throat swab specimen for culture is the current "gold standard" for diagnosing GAS pharyngitis (4). However, it is an imperfect test for use in school-based programs, as results are not available until the following day at the earliest (and up to 72 h after swabbing), and widespread swabbing suc...

We introduced polymerase chain reaction (PCR) testing for Neisseria gonorrhoeae (NG) on the Cobas 4800 CT/NG assay for all samples received with a Chlamdyia trachomatis request in March 2012. From 1 March 2012 to 30 June 2012, all PCR-positive/culture-negative specimens had additional testing at another assay. A total of 40053 tests were performed. The estimated specificity and positive predictive value were 99.9% and 97.1%, respectively; thus routine additional testing is not required.

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