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Gonorrhoea notifications and nucleic acid amplification testing in a very low-prevalence Australian female population.
Med J Aust. 2015 Apr 06; 202(6):321-3.MJ

Abstract

OBJECTIVES

To examine whether the rapid increase of gonorrhoea notifications in Victoria, Australia, identified by nucleic acid amplification test (NAAT) is supported by similar changes in diagnoses by culture, which has higher specificity, and to determine the proportion of tests positive among women tested.

DESIGN, SETTING AND PARTICIPANTS

Retrospective analysis of Medicare reporting of dual NAATs in Victoria, Victorian Department of Health gonorrhoea notifications, and gonorrhoea culture data at the Melbourne Sexual Health Centre (MSHC), among women, 2008 to 2013.

MAIN OUTCOME MEASURES

Gonorrhoea notifications and testing methods.

RESULTS

Gonorrhoea cases identified by NAAT increased from 98 to 343 cases over the study period. Notifications by culture alone decreased from 19 to five cases. The proportion of NAATs positive for gonorrhoea in Victoria was low (0.2%-0.3%) and did not change over time (P for trend, 0.66). Similarly, the proportion of women tested at the MSHC for gonorrhoea who tested positive (0.4%-0.6%) did not change over time (P for trend, 0.70). Of untreated women who had a positive NAAT result for gonorrhoea and were referred to the MSHC, 10/25 were confirmed by culture.

CONCLUSIONS

The positivity of gonorrhoea in women identified by culture remains stable over time. Using NAAT for gonorrhoea screening in low-prevalence populations will result in many false positives. Positive NAAT results among low-risk women should be regarded as doubtful, and confirmatory cultures should be performed.

Authors+Show Affiliations

Melbourne Sexual Health Centre, Melbourne, VIC, Australia. echow@mshc.org.au.Melbourne Sexual Health Centre, Melbourne, VIC, Australia.Melbourne Sexual Health Centre, Melbourne, VIC, Australia.Royal Women's Hospital Melbourne, Melbourne, VIC, Australia.University of Melbourne, Melbourne, VIC, Australia.Melbourne Sexual Health Centre, Melbourne, VIC, Australia.Melbourne Sexual Health Centre, Melbourne, VIC, Australia.Melbourne Sexual Health Centre, Melbourne, VIC, Australia.Melbourne Sexual Health Centre, Melbourne, VIC, Australia.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25832159

Citation

Chow, Eric P F., et al. "Gonorrhoea Notifications and Nucleic Acid Amplification Testing in a Very Low-prevalence Australian Female Population." The Medical Journal of Australia, vol. 202, no. 6, 2015, pp. 321-3.
Chow EP, Fehler G, Read TR, et al. Gonorrhoea notifications and nucleic acid amplification testing in a very low-prevalence Australian female population. Med J Aust. 2015;202(6):321-3.
Chow, E. P., Fehler, G., Read, T. R., Tabrizi, S. N., Hocking, J. S., Denham, I., Bradshaw, C. S., Chen, M. Y., & Fairley, C. K. (2015). Gonorrhoea notifications and nucleic acid amplification testing in a very low-prevalence Australian female population. The Medical Journal of Australia, 202(6), 321-3.
Chow EP, et al. Gonorrhoea Notifications and Nucleic Acid Amplification Testing in a Very Low-prevalence Australian Female Population. Med J Aust. 2015 Apr 6;202(6):321-3. PubMed PMID: 25832159.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gonorrhoea notifications and nucleic acid amplification testing in a very low-prevalence Australian female population. AU - Chow,Eric P F, AU - Fehler,Glenda, AU - Read,Tim R H, AU - Tabrizi,Sepehr N, AU - Hocking,Jane S, AU - Denham,Ian, AU - Bradshaw,Catriona S, AU - Chen,Marcus Y, AU - Fairley,Christopher K, PY - 2014/05/29/received PY - 2014/10/17/accepted PY - 2015/4/3/entrez PY - 2015/4/4/pubmed PY - 2015/6/18/medline SP - 321 EP - 3 JF - The Medical journal of Australia JO - Med. J. Aust. VL - 202 IS - 6 N2 - OBJECTIVES: To examine whether the rapid increase of gonorrhoea notifications in Victoria, Australia, identified by nucleic acid amplification test (NAAT) is supported by similar changes in diagnoses by culture, which has higher specificity, and to determine the proportion of tests positive among women tested. DESIGN, SETTING AND PARTICIPANTS: Retrospective analysis of Medicare reporting of dual NAATs in Victoria, Victorian Department of Health gonorrhoea notifications, and gonorrhoea culture data at the Melbourne Sexual Health Centre (MSHC), among women, 2008 to 2013. MAIN OUTCOME MEASURES: Gonorrhoea notifications and testing methods. RESULTS: Gonorrhoea cases identified by NAAT increased from 98 to 343 cases over the study period. Notifications by culture alone decreased from 19 to five cases. The proportion of NAATs positive for gonorrhoea in Victoria was low (0.2%-0.3%) and did not change over time (P for trend, 0.66). Similarly, the proportion of women tested at the MSHC for gonorrhoea who tested positive (0.4%-0.6%) did not change over time (P for trend, 0.70). Of untreated women who had a positive NAAT result for gonorrhoea and were referred to the MSHC, 10/25 were confirmed by culture. CONCLUSIONS: The positivity of gonorrhoea in women identified by culture remains stable over time. Using NAAT for gonorrhoea screening in low-prevalence populations will result in many false positives. Positive NAAT results among low-risk women should be regarded as doubtful, and confirmatory cultures should be performed. SN - 1326-5377 UR - https://www.unboundmedicine.com/medline/citation/25832159/Gonorrhoea_notifications_and_nucleic_acid_amplification_testing_in_a_very_low_prevalence_Australian_female_population_ L2 - https://www.mja.com.au/doi/10.5694/mja14.00780 DB - PRIME DP - Unbound Medicine ER -