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To estimate the number of unidentified cases, we performed an analysis based on a hypothetical cohort of 1000 patients assuming that those disclosing exposure would all be screened with a NAAT assay having 100% sensitivity and specificity.
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Organisms detected only by a NAAT were also regarded as clinically relevant, but with more stringent criteria than positive blood culture results.
Detection of N. gonorrhoeae, C. trachomatis and for M. genitalium using a NAAT is indicated in all patients.
Other researchers comparing culture with a gonorrhoea NAATs using endocervical samples have also performed the culture sample first, in view of the reduced sensitivity of culture.
All positive AC2 results were repeated with a second gonorrhoea NAAT, and were only reported as clinically positive if both tests were positive.
Of the 7 persons with negative NAAT results, 3 had a short interval between initial confirmatory test and last repeat negative confirmatory tests (< = 24 days).
The specificity of AC2 for gonorrhoea detection was excellent, but in a low prevalence setting, it is prudent to confirm a positive NAAT with a second test using a different target.
26 Essential pathways include those for obtaining informed consent for testing of gonorrhoea and for performing confirmatory testing (using a supplementary NAAT with a different nucleic acid target) before returning results to patients or initiating management.
With NAATs, a single bacterial cell, dead or alive, may contain multiples of a certain target sequence, e.g., in bacteria the conserved 16S rRNA gene sequence is often used as PCR template due to its high copy number in each cell.
Replacement of Xpert for adult pulmonary TB with POC sputum NAAT (i.e., a more deployable but equally accurate sputum-based test) resulted in more TB being diagnosed and treated, thus reducing pediatric TB incidence by 13.8% (UR 4.6-16.34.6-16.3%ulTBTB incidence by 11.1% (UR 2.7-11.92.7-11.9%
HIV antibody negative samples were retested with pooled NAAT.
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