Many remote Aboriginal and Torres Strait Islander communities in Australia experience unacceptable high rates of STIs such as chlamydia, gonorrhoea and trichomonas, despite efforts over many years to bring these infections under control.
A key public health strategy for control of curable STIs is the provision of accurate testing and timely treatment through primary care services.
Recent technological advances have led to the development of highly accurate point-of-care (POC) tests for STIs using the GeneXpert machine, based on nucleic acid amplification technology (NAAT).
The TTANGO(Test Treat ANd GO) research trial was carried out from 2011-2016 to determine the acceptability, performance and short term health impact of this new POC technology for the detection of chlamydia (CT) and gonorrhoea (NG) in remote communities.
The TTANGO Trial Final Report findings demonstrated:
Stakeholders, clinical staff and clients indicated POC testing for STIs was highly acceptable in remote and regional settings and made suggestions for future programs
The GeneXpert CT/NG test used by clinical staff at the point-of-care in these settings was as accurate as conventional laboratory-based tests for CT and NG
POC testing and use of these results to guide clinical management was associated with more timely treatment, reducing delays on average by 9 days
Building on from TTANGO, TTANGO2 aims to take the next key steps towards wider implementation of STI POC testing in high prevalence areas in regional and remote Australia (see 'where is the program active').
Through TTANGO2, STI POC testing for chlamydia, gonorrhoea and also trichomonas on the Cepheid GeneXpert is being implemented in a network of primary health services over a 5-year period to evaluate the long-term uptake, sustainability and impact of STI POC testing in these services.
POC testing (including enhanced continuous quality improvement, increased testing and retesting) should lead to better control of STIs with improved health outcomes for Aboriginal and Torres Strait Islander people, and national adoption of the POC test in similar settings. As part of TTANGO2 a Medicare submission will be made for a rebate for the GeneXpert POC test, to ensure the program is sustainable beyond the end of TTANGO2.