Michelle Loftus-Keeling's research while affiliated with Leeds Teaching Hospitals NHS Trust and other places
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Publications (10)
Introduction
BASHH, RCGP, and national laboratory, guidelines recommend that women with suspected bacterial vaginosis (BV) in primary care should be prescribed empirical antibiotic treatment based on symptoms +/- signs rather than diagnostic tests. This approach was adopted by sexual health clinics during the access restrictions of the COVID pandem...
Background
Sexual history does not accurately identify those with extragenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) so universal extragenital sampling is recommended. Nucleic acid amplification tests (NAATs) are expensive. If urogenital, plus rectal and pharyngeal, samples are analysed the diagnostic cost is trebled. Pooling sa...
Background:
Urogenital testing misses extragenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT). Extragenital self-sampling is frequently undertaken despite no robust RCT evidence of efficacy. We compared clinician-taken rectal and pharyngeal samples with self-taken samples for diagnostic accuracy and cost in MSM and females.
Methods...
Introduction
Extra-genital tests for gonorrhoea (NG) and chlamydia (CT) are important in MSM and increasingly in women as vulvovaginal swabs (VVS) alone can miss infections but rectum, pharynx and urogenital swabs treble the diagnostic cost.Self-sampling is frequently used despite no robust RCT assessing its efficacy. We compared clinician-taken ex...
Introduction
Bacterial vaginosis (BV) and candida are common problems among females using contraception. Associations between BV/candida and different contraception are described but not proven.
Aim(s)/objectives
Establish knowledge of BV/candida among contraceptive users. Assess whether future research on BV/candida and contraception would intere...
Introduction
A self versus clinician Chlamydia/gonorrhoea (CT/NG) NAAT swab trial, with pooling of self-taken samples, recruited January 2015–September 2016. There was concern that nucleic acid contamination of clinic surfaces could be a source of false-positive samples during the pooling process.
Aim(s)/objectives
To ascertain levels of environme...
Background
Extra-genital tests for gonorrhoea and chlamydia are important in MSM and are increasingly important in women as vulvovaginal swabs (VVS) alone can miss infections. Self-sampling is frequently used but there has been no robust RCT against clinician-taken samples in MSM or women to assess its efficacy.
Aim
To compare self-taken extra-gen...
Background/introduction
BASHH standards recommend rectal chlamydia sampling in women with increased risk. However, studies show high rates of rectal chlamydia in women, with concerns over treatment failures and risk of genital re-infection
Aim(s)/objectives
To determine if rectal chlamydia screening in females should be universal.
Methods
As part...
Background
Extra-genital infections are common in MSM and women and are frequently the sole sites of infection. However, analysing samples from the rectum and pharynx, in addition to the urogenital tract, trebles the diagnostic cost.
Aim
Can samples from three sites be pooled into one NAAT container and still achieve the same sensitivity and speci...
Background/introduction
Extragenital sampling for chlamydia and gonorrhoea is standard practice in MSM and is increasingly important in women. Some UK clinics offer self-swabbing from these sites, but little has been published about its acceptability, particularly in women. We explored this as part of a clinician versus self-swab study.
Methods
Wo...
Citations
... 8,12 The emergence of tests that allow for self-sampling and in some cases self-testing, and increasing public familiarity with the use of rapid tests during COVID-19 have enabled new opportunities. 13,14 Presently, the market for online STI testing services is rapidly expanding, with new public and private providers offering a range of service delivery options to test for chlamydia, gonorrhea, syphilis, and/or HIV. [15][16][17] Typically, users begin by completing a series of online screening questions. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272166079954953-1441900858566_Q64/Helen-Ward-10.jpg)
... Most often (94% of the time), ineligibility occurred because participants had not brought their swabs to the clinic visit; indeed, only 6% (n = 7) were ineligible because they made overt errors in the at-home specimen collection process. While this finding corresponds with the literature, which identifies that most people can complete self-swabbing with good accuracy [10,11,18], it also highlights a key item for those who wish to implement at-home swabbing for gonorrhea and chlamydia: consider making swabs available at laboratory drop-off locations, where patients can complete their swabs on-site when they provide urine and/or blood specimens for other testing. While our participants were still able to be tested (because they had presented to a clinic), if these patients had been completing at-home swabs which they deposited at laboratories for processing, some persons might have received incomplete testing (i.e., extragenital infections might have been missed if these persons forgot to bring swabs to the laboratory for testing). ...
... Self-sampling (thus with accurate laboratory testing) can be performed at a person's home, which is also referred to as homesampling. Self-sampling for urogenital and for extragenital NG and CT is comparable with clinician-administered samples (15)(16)(17). ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/667817393262612-1536231482662_Q64/Mark-Wilcox-4.jpg)
... Furthermore, testing multiple anatomic sites separately can increase costs and workload, especially when implementing testing at or near the point of care. Several studies have investigated the pooling of specimens from triple anatomic sites from a single individual, but its accuracy varied across studies [12][13][14]. Currently, there is no clear consensus whether pooling has adequate accuracy for populations at higher risk. ...
... Self-sampling (thus with accurate laboratory testing) can be performed at a person's home, which is also referred to as homesampling. Self-sampling for urogenital and for extragenital NG and CT is comparable with clinician-administered samples (15)(16)(17). ...
