PDF(Pubmed)
Abstract：
UNASSIGNED: Canadian Arctic communities have experienced sustained syphilis transmission, with diagnoses rates 18-times higher than the national average. Remoteness from laboratory facilities leads to delays between syphilis screening and treatment, contributing to onward transmission. Rapid diagnostic tests can eliminate treatment delays via testing at the point-of-care. This study aims to describe syphilis diagnostic gaps and to estimate the impact of introducing rapid diagnostic tests at the point-of-care on syphilis transmission.
UNASSIGNED: To assess the population-level impact of deploying rapid diagnostic tests, an individual-based model was developed using detailed surveillance data, population surveys, and a prospective diagnostic accuracy field study. The model was calibrated to syphilis diagnoses (2017-2022) from a community of approximately 1,050 sexually active individuals. The impacts of implementing rapid diagnostic tests using whole blood (sensitivity: 92% for infectious and 81% for non-infectious syphilis; specificity: 99%) from 2023 onward was calculated using the annual median fraction of cumulative new syphilis infections averted over 2023-2032.
UNASSIGNED: The median modeled syphilis incidence among sexually active individuals was 44 per 1,000 in 2023. Males aged 16-30 years exhibited a 51% lower testing rate than that of their female counterparts. Maintaining all interventions constant at their 2022 levels, implementing rapid diagnostic tests could avert a cumulative 33% (90% credible intervals: 18-43%) and 37% (21-46%) of new syphilis infections over 5 and 10 years, respectively. Increasing testing rates and contact tracing may enhance the effect of rapid diagnostic tests.
UNASSIGNED: Implementing rapid diagnostic tests for syphilis in Arctic communities could reduce infections and enhance control of epidemics. Such effective diagnostic tools could enable rapid outbreak responses by providing same-day testing and treatment at the point-of-care.
UNASSIGNED: Canadian Institutes of Health Research.
UNASSIGNED: To assess the population-level impact of deploying rapid diagnostic tests, an individual-based model was developed using detailed surveillance data, population surveys, and a prospective diagnostic accuracy field study. The model was calibrated to syphilis diagnoses (2017-2022) from a community of approximately 1,050 sexually active individuals. The impacts of implementing rapid diagnostic tests using whole blood (sensitivity: 92% for infectious and 81% for non-infectious syphilis; specificity: 99%) from 2023 onward was calculated using the annual median fraction of cumulative new syphilis infections averted over 2023-2032.
UNASSIGNED: The median modeled syphilis incidence among sexually active individuals was 44 per 1,000 in 2023. Males aged 16-30 years exhibited a 51% lower testing rate than that of their female counterparts. Maintaining all interventions constant at their 2022 levels, implementing rapid diagnostic tests could avert a cumulative 33% (90% credible intervals: 18-43%) and 37% (21-46%) of new syphilis infections over 5 and 10 years, respectively. Increasing testing rates and contact tracing may enhance the effect of rapid diagnostic tests.
UNASSIGNED: Implementing rapid diagnostic tests for syphilis in Arctic communities could reduce infections and enhance control of epidemics. Such effective diagnostic tools could enable rapid outbreak responses by providing same-day testing and treatment at the point-of-care.
UNASSIGNED: Canadian Institutes of Health Research.
摘要：
■加拿大北极社区经历了持续的梅毒传播，诊断率比全国平均水平高18倍。远离实验室设施会导致梅毒筛查和治疗之间的延误，有助于向前传播。快速诊断测试可以通过在护理点进行测试来消除治疗延迟。这项研究旨在描述梅毒的诊断差距，并评估在护理点引入快速诊断测试对梅毒传播的影响。
■为了评估部署快速诊断测试对人群水平的影响，使用详细的监测数据开发了基于个人的模型，人口调查,和前瞻性诊断准确性领域研究。该模型被校准为来自大约1,050名性活跃个体的社区的梅毒诊断（2017-2022）。从2023年开始，使用全血实施快速诊断测试的影响（感染性梅毒的敏感性：92％，非感染性梅毒的敏感性：81％；特异性：99％）是使用2023-2032年避免的累积新梅毒感染的年度中位数来计算的。
■2023年，性活跃个体的梅毒发病率中位数为44/1,000。16-30岁的男性的测试率比女性低51％。将所有干预措施保持在2022年的水平，实施快速诊断测试可以避免在5年和10年内累积33%(90%可信间隔:18-43%)和37%(21-46%)的新梅毒感染,分别。提高测试率和接触追踪可能会增强快速诊断测试的效果。
在北极社区实施梅毒快速诊断测试可以减少感染并加强对流行病的控制。这种有效的诊断工具可以通过在医疗点提供当天的检测和治疗来实现快速的疫情反应。
■加拿大卫生研究院。
■为了评估部署快速诊断测试对人群水平的影响，使用详细的监测数据开发了基于个人的模型，人口调查,和前瞻性诊断准确性领域研究。该模型被校准为来自大约1,050名性活跃个体的社区的梅毒诊断（2017-2022）。从2023年开始，使用全血实施快速诊断测试的影响（感染性梅毒的敏感性：92％，非感染性梅毒的敏感性：81％；特异性：99％）是使用2023-2032年避免的累积新梅毒感染的年度中位数来计算的。
■2023年，性活跃个体的梅毒发病率中位数为44/1,000。16-30岁的男性的测试率比女性低51％。将所有干预措施保持在2022年的水平，实施快速诊断测试可以避免在5年和10年内累积33%(90%可信间隔:18-43%)和37%(21-46%)的新梅毒感染,分别。提高测试率和接触追踪可能会增强快速诊断测试的效果。
在北极社区实施梅毒快速诊断测试可以减少感染并加强对流行病的控制。这种有效的诊断工具可以通过在医疗点提供当天的检测和治疗来实现快速的疫情反应。
■加拿大卫生研究院。
