Evaluation of the leukocyte esterase test (LET) as pre-screening test to reduce costs for national population-based Chlamydia trachomatis screening programs.
Explore the source record for details and available documents.
Biological Assay↗
Biomedical subjects
F de Groot
Publications and source records attributed to F de Groot.
Lessons learned from a population-based chlamydia screening pilot.
We evaluated process organization and response optimization in a home-based Chlamydia trachomatis (Ct) screening project in the Netherlands among 15- to 29-year-old women and men. The method used was computer-supported data flow, from population sampling to informing participants of the result. A new test kit or a letter reminded non-respondents after six weeks. Fifteen-year olds required parental consent. Urine arrived at the laboratory within 29 days from invitation, and four (1-11) days after collection, indicating good specimen quality. Test kits had a higher response than letters (15 versus 10%). Response in 15-year olds was 33%; with 2% Ct infected sexually active 15 year olds. In Conclusion, purpose made computer software is essential for an efficient screening programme. Sending urine by mail does not impair diagnostics. Reminders are necessary and effective after four weeks. Necessary parental consent for under 16-year olds should not be a deterrent to offer Ct screening to this age group.
Adolescent↗
Acceptability and consequences of screening for chlamydia trachomatis by home-based urine testing.
OBJECTIVE: The objective of this study was to study the acceptability and consequences of home-based chlamydia (CT) screening by Municipal Health Services (MHS) among 15- to 29-year-old participants. STUDY: This study consisted of a cross-section of 156 CT-positives and 600 random sampled CT-negatives after receiving the result of their CT test. RESULTS: Thirty-eight percent of the men and 59% of the women responded. The screening method was well-accepted. Seventy percent (52) of the CT-positives were surprised about their result. Infected women more often than men reported a feeling of being dirty and of anxiety about infertility. Curiosity for the CT result was decisive for participation in 68% and perception of personal risk was poor. The willingness to be tested regularly was determined by present chlamydial infection, young age, multiple lifetime partners, short relationship, and earlier test for chlamydia. CONCLUSIONS: Chlamydia screening organised by MHS is acceptable for future screening. Participants with an elevated risk are interested in screening as long as test kits are easily available. Counseling with focus on effects of CT, especially on women, is essential. Alternative approaches are needed to motivate men and non-Dutch high-risk groups.
Adolescent↗
A prediction rule for selective screening of Chlamydia trachomatis infection.
BACKGROUND: Screening for Chlamydia trachomatis infections is aimed at the reduction of these infections and subsequent complications. Selective screening may increase the cost effectiveness of a screening programme. Few population based systematic screening programmes have been carried out and attempts to validate selective screening criteria have shown poor performance. This study describes the development of a prediction rule for estimating the risk of chlamydial infection as a basis for selective screening. METHODS: A population based chlamydia screening study was performed in the Netherlands by inviting 21,000 15-29 year old women and men in urban and rural areas for home based urine testing. Multivariable logistic regression was used to identify risk factors for chlamydial infection among 6303 sexually active participants, and the discriminative ability was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with bootstrap resampling techniques. RESULTS: The prevalence of C trachomatis (CT) infection was 2.6% (95% CI 2.2 to 3.2) in women and 2.0% (95% CI 1.4 to 2.7) in men. Chlamydial infection was associated with high level of urbanisation, young age, Surinam/Antillian ethnicity, low/intermediate education, multiple lifetime partners, a new contact in the previous two months, no condom use at last sexual contact, and complaints of (post)coital bleeding in women and frequent urination in men. A prediction model with these risk factors showed adequate discriminative ability at internal validation (AUC 0.78). CONCLUSION: The prediction rule has the potential to guide individuals in their choice of participation when offered chlamydia screening and is a promising tool for selective CT screening at population level.
Adolescent↗
High-resolution X-ray emission and X-ray absorption spectroscopy.
Explore the source record for details and available documents.
Journal Article↗
Tetrahydrobiopterin regulates superoxide and nitric oxide generation by recombinant endothelial nitric oxide synthase.
Nitric oxide (NO) produced by the endothelial isoform of nitric oxide synthase (NOS III) is a key determinant of the anti-atherosclerotic properties of the endothelium. Recent in vivo studies suggest that NOS III may also be a source of superoxide production, which would limit its role as a NO-producing enzyme. In the current study we examined both the NO and the superoxide generating potential of recombinant NOS III obtained from a baculovirus/Sf9 expression system. Using lucigenin chemiluminesence we could indeed demonstrate (superoxide dismutase inhibitable) superoxide production by NOS III. This superoxide production was not affected by administration of L-arginine, but could be inhibited dose-dependently by the co-factor tetrahydrobiopterin (BH4). BH4 also dose dependently decreased superoxide generation by hypoxanthine/xantine oxidase suggesting a direct antioxidant effect. Superoxide generation by NOS III could be completely inhibited by diphenyleneiodonium (DPI), an inhibitor of the flavin moiety of the enzyme, indicating that this group is a main source of superoxide production by the enzyme. Using measurement of [3H-L-arginine] conversion to [3H-L-citrulline], it appeared that BH4 directly increased the production of NO by NOS III. In addition, we observed that BH4 stablized the NOS III in its dimeric form, suggesting that an effect on allosteric conformation could be involved in this effect on NO production. NOS III thus appears to be a superoxide generating enzyme probably through its flavin moiety, as well as a BH4-dependent NO producing enzyme.
Animals↗
[Health education in Burundi: peer education in practice].
Because almost half of the patients diagnosed in health centers in Burundi suffered from illnesses related to impure water or inadequate sanitation, the Hygiene Education and Training Programme was created to assure the efficient use of water and sanitation infrastructures by the population of Burundi. A specific organizational unit, linked to the ministry of Public Health was created to implement the programme. With the objective of changing non-hygienic behaviour related to water use and sanitation, hygiene education was carried out by field teams using interpersonal peer communication methods in people's homes during a series of education campaigns that each last three months. The programme was directed primarily to households composed of men, women and children, with particular attention given to women and children, who have the primary responsibility for household hygiene. A participatory approach was employed that used teams of volunteers chosen by and from the population, and who visited households twice during each campaign. Audiovisual materials and messages for each campaign were developed in collaboration with the population. The field teams were motivated by a regular programme of training, an intense support and monitoring system, and the availability of audiovisual materials for hygiene education, as well as a system of prizes that was added recently. After 18 months of experience, it is possible to say that the approach is both feasible and effective. The population reacted positively to the hygiene education that was offered and a degree of behaviour change was observed.
Burundi↗