IMPACT OF NAAT’S ON

DIAGNOSIS OF STD’S
MARY CHIKWAKWA
PATRICK MISOMALI
HAMZY SELEMANI
OBJECTIVES
• Introduction
• Advantages of NAATs
• Challenges associated with NAATs
• Solutions to challenges
• Conclusion
• Study by katz
Introduction
Nucleic acid amplification tests (NAATs) are a type of molecular
diagnostic method used to detect and amplify the presence of specific
nucleic acids, such as DNA or RNA, in a given sample

It is used for detection of sexually transmitted infections, particularly

Neisseria gonorrhoeae and Chlamydia trachomatis.
Advantages of NAATs
Easy to use
Highly sensitive
Transportation is less demanding
Allows temporary storage of specimens at collection point
Identifies missed infections by traditional culture methods
Allows mass screening of STDs
Challenges associated with NAATs

Costly
Cost due to technological advancement
Overtesting
Overbilling…e.g Gene Probe APTMA Combo 2 Assay

 Less specific in low prevalence populations

Solutions to the challenges
 Products manufactures allow the test systems to be virtually
unbundled by turning off the software that reads results, allowing
determination of the single analyte result.

 The change of reimbursement formula, allowing only reimbursement

for one STD assay regardless of the number of analytes
Solutions…….
 Clinicians should prevent tanta-mount to malpractice of not taking
patients history

 Education to physician on the proper use of screening test

 Hospital should provide recommendation in the absence of data to

prevent misuse of resources.
conclusion

• The article recognizes the benefits of molecular diagnostics in STD

screening
• It also emphasizes the importance of using these tools wisely to avoid
overinterpretation, overuse, and overbilling
• Which, when not properly used, it overshadow the potential benefits
of the molecular revolution in STD prevention and control
false-positive gonorrhea test results with NAATs: The
impact of low prevalence on positive predictive value
• A study done by Alan R. Katz
• Five erroneous positive gonorrhea test results from private lab
prompted at Hawaii state Department of Health Investigation.
• Despite no unusual patterns in positive test results, the overall
positive gonorrhea test rate was 1.06%, with a calculated positive
predictive value(PPV) of 60%.
• Lack of sexual history documentation highlighted the importance of
considering false positives and understanding the impact of low
prevalence on screening tests in STD assessments.
referrences
• Dr. Jeffrey D. Klausner, San Francisco Dept. of Public Health, 1360
Mission St., Ste. 401, San Francisco, CA 94103
(Jeff.Klausner@sfdph.org).
• Katz AR, Effler PV, Ohye RG, Brouillet B, LeeMVC, Whiticar PM. Clin
Infect Dis 2004; 38:814–9
Thank You.