Home-based versus clinic-based specimen collection in the management of Chlamydia trachomatis and Neisseria gonorrhoeae infections

Fajardo-Bernal, Luisa M.; Aponte-González, Johanna; Vigil, Patrick D.; Angel‐Müller, Edith; Rincón, Carlos; Gaitán, Hernando; Low, Nicola

doi:10.1002/14651858.cd011317.pub2

Cited by 41 publications

(52 citation statements)

References 51 publications

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“…In a meta-analysis comparing home based with clinic based specimen collection in the management of Chlamydia trachomatis and Neisseria gonorrhoeae infections among sexually active people for the outcome of uptake, there was no overall sex-treatment interaction based on the two randomized controlled trials that included data for both men and women. 50 Both trials had found statistically significant sex-treatment interactions, but the stratified results were in opposite directions. This serves as an important reminder that healthcare providers should exercise caution and clinical judgment when interpreting subgroup results from a single study.…”

Section: Discussionmentioning

confidence: 98%

Sex based subgroup differences in randomized controlled trials: empirical evidence from Cochrane meta-analyses

Wallach

Sullivan

Trepanowski

et al. 2016

BMJ

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Objective To evaluate the frequency, validity, and relevance of statistically significant (P<0.05) sex-treatment interactions in randomized controlled trials in Cochrane meta-analyses.Design Meta-epidemiological study.Data sources Cochrane Database of Systematic Reviews (CDSR) and PubMed.Eligibility criteria for study selection Reviews published in the CDSR with sex-treatment subgroup analyses in the forest plots, using data from randomized controlled trials.Data extraction Information on the study design and sex subgroup data were extracted from reviews and forest plots that met inclusion criteria. For each statistically significant sex-treatment interaction, the potential for biological plausibility and clinical significance was considered.Results Among the 41 reviews with relevant data, there were 109 separate treatment-outcome analyses (“topics”). Among the 109 topics, eight (7%) had a statistically significant sex-treatment interaction. The 109 topics included 311 randomized controlled trials (162 with both sexes, 46 with males only, 103 with females only). Of the 162 individual randomized controlled trials that included both sexes, 15 (9%) had a statistically significant sex-treatment interaction. Of four topics where the first published randomized controlled trial had a statistically significant sex-treatment interaction, no meta-analyses that included other randomized controlled trials retained the statistical significance and no meta-analyses showed statistical significance when data from the first published randomized controlled trial were excluded. Of the eight statistically significant sex-treatment interactions from the overall analyses, only three were discussed by the CDSR reviewers for a potential impact on different clinical management for males compared with females. None of these topics had a sex-treatment interaction that influenced treatment recommendations in recent guidelines. UpToDate, an online physician-authored clinical decision support resource, suggested differential management of men and women for one of these sex-treatment interactions.Conclusion Statistically significant sex-treatment interactions are only slightly more frequent than what would be expected by chance and there is little evidence of subsequent corroboration or clinical relevance of sex-treatment interactions.

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Section: Discussionmentioning

confidence: 98%

Sex based subgroup differences in randomized controlled trials: empirical evidence from Cochrane meta-analyses

Wallach

Sullivan

Trepanowski

et al. 2016

BMJ

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“…A systematic review of randomised control trials investigating home-based versus clinic-based specimen collection for gonococcal and chlamydial detection found no difference in completing testing, diagnosis and treatment between the two methods. 73 Detection rates for pharyngeal and rectal NG or CT were equal or better with self-collection compared with provider-collection in a study on the reliability of self-testing in MSM. 74 Home-based self-collection of specimens may be comparable to clinic-based testing and is being evaluated by the 'I Want the Kit' (IWTK) program.…”

Section: Delivery Of Sexual Health Services For Msmmentioning

confidence: 93%

Sexually transmissible infection control programs for men who have sex with men – what will they look like in 2020?

et al. 2017

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Abstract. The resurgence of sexually transmissible infections among men who have sex with men is a concern for sexual health. Traditional strategies have relied on the promotion of condom use, regular testing, treatment, and partner management. Future sexually transmissible infection control programs must combine current prevention methods with novel approaches that target the providers, patients, and mechanisms of health care delivery.

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“…Recently it has been shown that the availability of chlamydia test results may induce a change in sexual behaviour in Dutch women [52]. Thus, availability of home-based specimen selfcollection for C. trachomatis and N. gonorrhoeae testing might improve STI control, prevention and management [53].…”

Section: Discussionmentioning

confidence: 99%

The challenges of preexposure prophylaxis for bacterial sexually transmitted infections

Dubourg

Raoult

2016

Clinical Microbiology and Infection

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Preexposure prophylaxis (PrEP) against HIV is currently the subject of great interest, as clinical trials have shown high efficacy in terms of decreasing transmission among men who have sex with men. Because the prevalence of bacterial sexual transmitted infections (STIs) is increasing within this community, a recent pilot study demonstrated the efficacy of reducing transmission of bacterial STIs by administering PrEP with daily doxycycline to men who have sex with men. This creative initiative raises several questions which are discussed in this review. Relevant information should be drawn from the huge amount of available epidemiologic data to identify those who could benefit from such prophylactic treatment. The choice of antimicrobial agents is crucial, as antimicrobial susceptibility of STI agents is heterogeneous. Finally, we discuss challenges to improve the control of STIs through the use of PrEP.

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Home-based versus clinic-based specimen collection in the management of Chlamydia trachomatis and Neisseria gonorrhoeae infections

Cited by 41 publications

References 51 publications

Sex based subgroup differences in randomized controlled trials: empirical evidence from Cochrane meta-analyses

Sex based subgroup differences in randomized controlled trials: empirical evidence from Cochrane meta-analyses

Sexually transmissible infection control programs for men who have sex with men – what will they look like in 2020?

The challenges of preexposure prophylaxis for bacterial sexually transmitted infections

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