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Viability and acceptability of self-sampling as a primary screening method for sexually transmitted infections in female Kobe University students

Bule, Yara Priscilla Nagai, Yurie Kameoka, Masanori 神戸大学

2023

概要

According to the World Health Organisation's (WHO) 2021 Global Progress Report, more than 1 million
curable sexual transmitted infections (STIs) are acquired every day, with incidence rates of 374 million
STIs per year, of which, 128 million cases are of Chlamydia trachomatis, 82 million cases are of Neisseria
gonorrhoeae, 7 million cases are of Treponema pallidum (syphilis) and 156 million cases are of
Trichomonas vaginalis.[1] Additionally, 291 million women are Human Papillomavirus (HPV) DNA
carriers and 500 million test positive for genital herpes simplex virus (HSV-2).[2, 3]
A study by Kawado et. al. reported that the number of newly diagnosed cases in 2015 were 244 for
chlamydia, 87 for genital herpes and 89 for gonorrhoea per 100,000 population.[4] Moreover, the Japanese
National Institute of Infectious Diseases reported over 2,500 confirmed cases of syphilis infection by April
2022, confirming a significant rise of new cases compared to the previous years.[5] It was also reported
that cervical cancer (CC) has an incidence rate of 13,277 new diagnoses per year and mortality rate of 4,088
deaths per year, in women 15 years and older.[6] Young adults and adolescents are among the group of
people most vulnerable to STIs,[7] and as STI rates continue to increase in various countries around the
world and in Japan, it is imperative to reduce barriers to STI screening and sexual education.[8]
Screening programs are important to help evaluate, diagnose, treat and provide education in underscreened and hard-to-reach populations. Furthermore, screening methods should be cost effective, easily
transportable, stored, and accessed. To combat STIs and other gynaecological morbidities such as, HPV,
N. gonorrhoeae, C. trachomatis, T. pallidum and T. vaginalis, WHO guidelines give strong to conditional
recommendation to self-collected samples as an additional approach to STI testing services giving credence
to the use of self-sampling as a primary screening method in multiple countries worldwide.[9-11] Aside
from having characteristics of a good screening method, it also allows for patient privacy and comfort. The
type of self-sampling collection tools can be very diverse. Amongst them, dry swabs have been reported to
be a safe self-sampling collection tool with accurate and reliable results, even when dry stored at room
temperature for several days. [12-15] Furthermore, self-collected samples coupled with DNA testing, have
been shown to have the same and at times, higher sensitivity and specificity the conventional methods, with
no significant differences between self-sampling tools.[16-18]
Some of the WHO’s priorities for tackling STIs globally, for the next decade, is to (1) scale up pointof-care diagnostics and self-testing, (2) Integrate sexual and reproductive health and rights, (3) Address
social and structural determinants, (4) Maximise the use of differentiated and people-centred service
delivery options and (5) Strengthen community engagement, community-based service delivery and
community-led monitoring.[1] In this study, we aim to address the priorities, above mentioned, within the
context of the Kobe University community. The project’s goal is to obtain information regarding STI
prevalence and assess the viability and acceptability of the self-sampling methods. ...

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