Chlamydia Trachomatis and Neisseria Gonorrhoea Point-of-Care Testing in the UK: Is This a Necessary Venture or an Impractical Folly?

Background:  UK STI clinics routinely use Chlamydia trachomatis (CT) and Neisseria gonorrhoea (GC) nucleic acid amplification tests (NAAT), with results available within two to seven days suggesting there may be potential for CT and GC point of care tests (POCT). Studies have shown the sensitivity and specificity of the CT POCT to be above 90% and a result can be produced in 30 minutes. The study assessed the time service-users were prepared to wait in clinic for a CT/GC POCT result and analysed the impact a POCT would have on preventing loss to follow-up and subsequent re-presentations.

Methods:  1400 patients attending a level 3 sexual health clinic in the UK were recruited and surveyed on the maximum time they were prepared to wait for a result if a CT/GC POCT were available. Subsequent infection rates diagnosed on NAAT and follow-up episodes were reviewed. Chi-squared analysis was used to compare the infection rates among time category groups.

Results: Preliminary results suggest that most patients were not willing to wait for a POCT result in clinic longer than 30 minutes. The majority of individuals with infections were treated and followed up appropriately. All individuals with CT/GC were informed and no individuals were left untreated. Full results will be available at conference.

Conclusions: CT and GC POCT would be of limited benefit if introduced in the UK. The current system in the UK using NAAT and recalling patients with positive results to clinics has a minimal default rate and is well developed. There may be a place for such POCT in outreach settings or healthcare systems where access to STI clinics is limited or final treatment and cure rates are poor with central laboratory testing.