Gonorrhoea test leading to over diagnosis
The overuse of the nucleic acid amplification test (NAAT) for gonorrhoea in women who are at low risk is resulting in false-positive results and over diagnosis, and is probably leading to unnecessary treatment, according to research, led by Dr Eric Chow, which was published in the Medical Journal of Australia this week.
In a linked MJA editorial, Dr Katy Bell and her co-authors write that screening for gonorrhoea in women who are at low risk has become increasingly common because of dual testing for chlamydia and gonorrhoea. They argued that misdiagnosis via the NAAT is causing unnecessary physical and psychological harm in patients.
Chow et al and Bell et al suggested that limiting the routine screening to higher-risk populations with higher underlying rates of infection was one solution.
Bell and colleagues concluded their article by saying that the take-home messages to primary care physicians are that false-positive results are likely if an NAAT is used on its own in a low-risk population, and further tests (supplementary NAAT and culture) and repeat tests may be the best strategy for dealing with an initial positive NAAT result.