title: Point-of-care testing for chlamydia and gonorrhoea: implications for clinical practice.
abstract: OBJECTIVE
  Point-of-care (POC) testing for chlamydia (CT) and gonorrhoea (NG) offers a new approach to the diagnosis and management of these sexually transmitted infections (STIs) in remote Australian communities and other similar settings. Diagnosis of STIs in remote communities is typically symptom driven, and for those who are asymptomatic, treatment is generally delayed until specimens can be transported to the reference laboratory, results returned and the patient recalled. The objective of this study was to explore the clinical implications of using CT/NG POC tests in routine clinical care in remote settings.
  
  
  METHODS
  In-depth qualitative interviews were conducted with a purposively selected group of 18 key informants with a range of sexual health and laboratory expertise.
  
  
  RESULTS
  Participants highlighted the potential impact POC testing would have on different stages of the current STI management pathway in remote Aboriginal communities and how the pathway would change. They identified implications for offering a POC test, specimen collection, conducting the POC test, syndromic management of STIs, pelvic inflammatory disease diagnosis and management, interpretation and delivery of POC results, provision of treatment, contact tracing, management of client flow and wait time, and re-testing at 3 months after infection.
  
  
  CONCLUSIONS
  The introduction of POC testing to improve STI service delivery requires careful consideration of both its advantages and limitations. The findings of this study will inform protocols for the implementation of CT/NG POC testing, and also STI testing and management guidelines.
authors: The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia; The Burnet Institute, Melbourne, Victoria, Australia.
authors: Lisa
authors: L
authors: Natoli
authors: The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
authors: Lisa
authors: L
authors: Maher
authors: Flinders University International Centre for Point of-Care Testing, Flinders University, Adelaide, South Australia, Australia.
authors: Mark
authors: M
authors: Shephard
authors: Apunipima Cape York Health Council, Cairns, Queensland, Australia.
authors: Belinda
authors: B
authors: Hengel
authors: Ngaanyatjarra Health Service, Alice Springs, Northern Territory, Australia.
authors: Annie
authors: A
authors: Tangey
authors: The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
authors: Steven G
authors: SG
authors: Badman
authors: Baker IDI, Alice Springs, Northern Territory, Australia.
authors: James
authors: J
authors: Ward
authors: The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
authors: Rebecca J
authors: RJ
authors: Guy
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D002689:Chlamydia / Q000302:isolation & purification*; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000208:ethnology / Q000382:microbiology; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000175:diagnosis* / Q000208:ethnology / Q000382:microbiology; D006801:Humans; D007753:Laboratories; D008297:Male; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D019095:Point-of-Care Systems / Q000458:organization & administration*; D011379:Prognosis; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic; D060728:Reproductive Health; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*