P099 TV or not TV: using naats to improve the cost effectiveness of testing

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IntroductionIn April 2016, we changed from TV culture to BD Viper NAATs testing and from testing all women to only testing women who were symptomatic, STI contacts, had previous TV and male contacts of TV.MethodsLaboratory data and SHHAPT codes retrospectively identified all patients diagnosed with TV between 1 May – 30 November 2016. Electronic patient records (EPR) were reviewed and data analysed in Excel.ResultsThere were 96 new diagnoses, 93 females and 3 males, median age 31 (IQR 24–40). 66% Black Afro-Caribbean; 3 were sex workers. 91% symptomatic, 22% had STI co-infection, 26% bacterial vaginosis, 7% candida and 32% previous TV.Wet prep microscopy (WPM) detected 65% of symptomatic cases. Treatments were Metronidazole or Tinidazole.The audit standards our service achieved (BASHH performance standards target- 97%) were: 100% received appropriate antibiotics, 51% written information receipt documented, 90% had partner notification recommended (PN) and 28% PN confirmation.DiscussionTV NAATs cost more than culture but changing our protocol reduced the overall cost while increasing the number of new diagnoses; enabling us to target testing to patients at highest risk. 35% (27) were missed on WPM. 9.3% (9) were asymptomatic and detected because of testing as contacts of TV/sex worker/cervical cytology detection. Recommendations include: staff training to improve completion of PN and modifying our EPR fields to improve documentation of leaflets having been given.

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