The diagnostic accuracy of pooled testing from multiple individuals for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae: a systematic review

Xu, Yao; Aboud, Lily; Chow, Eric P F; Mello, Maeve B.; Wi, Teodora; Baggaley, Rachel; Fairley, Christopher K; Peeling, Rosanna W.; Ong, Jason J.

doi:10.1016/j.ijid.2022.03.009

Cited by 7 publications

(4 citation statements)

References 29 publications

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“…2,23,24 By pooling samples, programs can save time and resources, and pooling appears to provide adequate precision even at low prevalence levels. 25 Current PCR platforms such as Abbott m2000 can test up to 480 samples per run, and therefore could provide results in time to allow programmatic decision making.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Ocular Chlamydia trachomatis Infection in Amhara Region, Ethiopia, after 8 Years of Trachoma Control Interventions

Nash

Chernet

Weiss

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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Although trachoma mass drug administration (MDA) programs target ocular Chlamydia trachomatis, the global trachoma control program does not monitor infection as a measure of impact but instead relies on monitoring clinical indicators. This study aimed to monitor the prevalence of ocular C. trachomatis among a population-based sample of children ages 1–5 years throughout Amhara, Ethiopia, a region that has received approximately 8 years of annual MDA as part of trachoma control. Between 2014 and 2021, trachoma impact surveys and surveillance surveys were conducted in all 156 districts of Amhara using a multistage cluster randomized methodology. Certified graders assessed individuals ages ≥ 1 year for trachomatous inflammation-follicular (TF), and a random subset of children ages 1–5 years also provided a conjunctival swab. Polymerase chain reaction was used to test for C. trachomatis. A total of 28,410 conjunctival swabs were collected from children ages 1–5 years across Amhara. The regional C. trachomatis infection prevalence was 4.7% (95% uncertainty interval: 4.3–5.1%). Infection was detected in all 10 zones of the region and ranged from 0.2% in Awi Zone to 11.9% in Waghemra Zone. Infection was detected in 17 (26%) districts with a TF prevalence < 10% and in 7 (21%) districts with a TF prevalence < 5%. Through programmatic monitoring of C. trachomatis infection, this study demonstrated that considerable infection remained throughout Amhara despite approximately 8 years of trachoma interventions and that enhanced interventions such as more frequent than annual MDA will be needed if elimination thresholds are to be reached.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Ocular Chlamydia trachomatis Infection in Amhara Region, Ethiopia, after 8 Years of Trachoma Control Interventions

Nash

Chernet

Weiss

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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“…Furthermore, the generically programmed pipeline of the Segtnan™ AIP is ready to be clinically validated and used for pooling in other pathogens, e.g. HIV 2 , Chlamydia 29 , Malaria 30 , and Tuberculosis 31 . However, the data-driven pool size equations for these diseases (similar to SE) are yet open to be investigated.…”

Section: Discussionmentioning

confidence: 99%

Clinical performance of AI-integrated risk assessment pooling reveals cost savings even at high prevalence of COVID-19

Kamari,

Eller,

Bøgebjerg

et al. 2024

Sci Rep

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Individual testing of samples is time- and cost-intensive, particularly during an ongoing pandemic. Better practical alternatives to individual testing can significantly decrease the burden of disease on the healthcare system. Herein, we presented the clinical validation of Segtnan™ on 3929 patients. Segtnan™ is available as a mobile application entailing an AI-integrated personalized risk assessment approach with a novel data-driven equation for pooling of biological samples. The AI was selected from a comparison between 15 machine learning classifiers (highest accuracy = 80.14%) and a feed-forward neural network with an accuracy of 81.38% in predicting the rRT-PCR test results based on a designed survey with minimal clinical questions. Furthermore, we derived a novel pool-size equation from the pooling data of 54 published original studies. The results demonstrated testing capacity increase of 750%, 60%, and 5% at prevalence rates of 0.05%, 22%, and 50%, respectively. Compared to Dorfman’s method, our novel equation saved more tests significantly at high prevalence, i.e., 28% (p = 0.006), 40% (p = 0.00001), and 66% (p = 0.02). Lastly, we illustrated the feasibility of the Segtnan™ usage in clinically complex settings like emergency and psychiatric departments.

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“…In summary, this study provides novel insights into specific risk factors associated with chlamydia in 12 provinces of China. Given that most chlamydia infections are asymptomatic and no vaccine is currently available (25), the backbone of chlamydia prevention should include not only behavioral interventions but also early screening programs to identify and treat individuals with genital tract infections (26) detecting missed infections that could lead to reproductive complications, reducing the prevalence and economic burden of trachomatis infections.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of and risk factors for chlamydia in female outpatients with genital tract infections: a nationwide multi-center, cross-sectional study in China

Li,

Liu,

Zhang

et al. 2023

Front. Public Health

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IntroductionChlamydia trachomatis is the etiological agent of the commonest sexually transmitted bacterial infection. This study aimed to examine the prevalence of genital chlamydia and associated risk factors in Chinese female outpatients with genital tract infections.MethodsA prospective, multicenter epidemiological study of genital chlamydia prevalence in 3008 patients with genital tract infections in 13 hospitals in 12 provinces of China was performed between May 2017 and November 2018. Vaginal secretion specimens were collected for the clinical diagnosis of vaginitis, whereas cervical secretion specimens were tested for Chlamydia trachomatis and Neisseria gonorrhoeae. All patients participated in a one-on-one cross-sectional questionnaire interview. ResultsTotally 2,908 participants were included. The prevalence rates of chlamydia and gonococcal infections in women with genital tract infections were 6.33% (184/2908) and 0.01% (20/2908), respectively. Multivariate analysis showed high risk factors for chlamydia were premarital sex behavior, first sexual intercourse before the age of 20 and bacterial vaginosis.DiscussionGiven that most chlamydia cases are asymptomatic and no vaccine is currently available, chlamydia prevention strategies should include behavioral interventions as well as early screening programs to identify and treat individuals with genital tract infections, especially those with the above identified risk factors.

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The diagnostic accuracy of pooled testing from multiple individuals for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae: a systematic review

Cited by 7 publications

References 29 publications

Prevalence of Ocular Chlamydia trachomatis Infection in Amhara Region, Ethiopia, after 8 Years of Trachoma Control Interventions

Prevalence of Ocular Chlamydia trachomatis Infection in Amhara Region, Ethiopia, after 8 Years of Trachoma Control Interventions

Clinical performance of AI-integrated risk assessment pooling reveals cost savings even at high prevalence of COVID-19

Prevalence of and risk factors for chlamydia in female outpatients with genital tract infections: a nationwide multi-center, cross-sectional study in China

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