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

• Published in: Public health action 2024-03, Vol.14 (1), p.14-19
• Main Authors: Tsorou, C., Williams, A., van den Boogaard, W., Staderini, N., Repetto, E., Terzidis, A., Pikoulis, E.
• Format: Article
• Language: English
• Subjects: Antimicrobial Resistance; Chlamydia Trachomatis; Genexpert Ct/ng Test; Neisseria Gonorrhoeae; Sort It; Structured Operational Research And Training Initiative
• ISSN: 2220-8372; 2220-8372
• DOI: 10.5588/pha.23.0022

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.