Gonorrhoea test leading to false positive results

A PARTICULAR gonorrhoea test is being overused and leading to false positive results research in the Medical Journal of Australia has found.

Researchers from the Melbourne Sexual Health Centre, Monash University, Royal Women's Hospital Melbourne and University of Melbourne, led by Dr Eric Chow, found while the number of positive results for gonorrhoea in Victorian women tested by the nucleic acid amplification test tripled between 2008 and 2013, the prevalence of cases confirmed by culture did not change over time.

"There was no observable increase in the proportion of women diagnosed with gonorrhoea by culture at the MSHC, or in the proportion of notifications per reported [Medicare Benefits Schedule] item numbers for dual NAAT in Victoria", the researchers wrote.

"Taken collectively, these data suggest that the prevalence of gonorrhoea among women remains very low and stable in Victoria (0.2%-0.3%) and at the MSHC (0.4%-0.6%), and that the rise in notifications is likely due to false-positive results arising from the increased use of NAATs in a low prevalence population, with potential for unnecessary treatment of patients and partners and consequent harm."

In a separate Medical Journal of Australia editorial Dr Katy Bell, and co-authors, said testing for gonorrhoea had grown increasingly common.

"Two factors which may partly account for the increase in testing are ... clinicians misinterpreting guidelines as meaning that opportunistic screening should be done for both infections, and ... use of dual NAATs by laboratories to test for both infections, even when clinicians have only requested chlamydia testing," Dr Bell wrote.

"The psychological consequences of false-positive test results are substantial.

"They include anxiety and depression, feelings of guilt and self-blame loss of self-esteem and self-confidence, feelings of social isolation, and existential concerns."

The research as well as the editorial suggested limiting the routine screening to higher-risk populations with higher underlying rates of infection was one solution.


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