Forest plot of gonorrhea self-sampling compared to clinician sampling.

<p>Forest plot of gonorrhea self-sampling compared to clinician sampling.</p

PRISMA flowchart of identification and selection of studies.

<p>PRISMA flowchart of identification and selection of studies.</p

Forest plot of the accuracy of chlamydia self-collection compared to clinician collection.

<p>Forest plot of the accuracy of chlamydia self-collection compared to clinician collection.</p

HSROC plots of chlamydia self-collection compared to clinician-collection (top row) and HSROC plots of chlamydia self-sampling by assay type (bottom row).

<p><u>Top row</u>: The circles represent individual studies and size of the circle is proportional to the number of patients included in the study. The red square is the summary estimate of sensitivity and specificity, and the red dotted ellipse around the spots respresents the 95% confidence interval around the summary estimate. The green dotted ellipse around the spots represents the prediction contours outlining the prediction region for the true sensitivity and specificity in a future study. <u>Bottom row</u>: Coloured lines represent the HSROC curve by assay type in Chlamydia studies.</p

Fixed effects sROC plots of gonorrhea studies comparing self-collected urine to either clinician-collected urethra (left) or cervical (right) samples by PCR assay type.

<p>Colored lines represent the sROC curve by assay type.</p

Additional file 1: of Comparison of the Roche cobasÂŽ 4800 and Digene Hybrid CaptureÂŽ 2 HPV tests for primary cervical cancer screening in the HPV FOCAL trial

Table S1. Baseline Digene HC2/Roche COBAS Results Stratified by LA and Cytology. Table S2. Baseline Digene HC2 and Roche COBAS Abnormal Cytology Rates Stratified by Linear Array Genotyping. (DOCX 16 kb

Are Interferon-Free Direct-Acting Antivirals for the Treatment of HCV Enough to Control the Epidemic among People Who Inject Drugs?

<div><p>Background</p><p>Widely access to interferon-free direct-acting antiviral regimens (IFN-free DAA) is poised to dramatically change the impact of the HCV epidemic among people who inject drugs (PWID). We evaluated the long-term effect of increasing HCV testing, treatment and engagement into harm-reduction activities, focused on active PWID, on the HCV epidemic in British Columbia (BC), Canada.</p><p>Methods</p><p>We built a compartmental model of HCV disease transmission stratified by disease progression, transmission risk, and fibrosis level. We explored the effect of: (1) Increasing treatment rates from 8 to 20, 40 and 80 per 1000 infected PWID/year; (2) Increasing treatment eligibility based on fibrosis level; (3) Maximizing the effect of testing by performing it immediately upon ending the acute phase; (4) Increasing access to harm-reduction activities to reduce the risk of re-infection; (5) Different HCV antiviral regimens on the Control Reproduction Number <i>R</i>_<i>c</i>. We assessed the impact of these interventions on incidence, prevalence and mortality from 2016 to 2030.</p><p>Results</p><p>Of all HCV antiviral regimens, only IFN-free DAAs offered a high chance of disease elimination (i.e. <i>R</i>_<i>c</i> < 1), but it would be necessary to substantially increase the current low testing and treatment rates. Assuming a treatment rate of 80 per 1000 infected PWID per year, coupled with a high testing rate, the incidence rate, at the end of 2030, could decrease from 92.9 per 1000 susceptible PWID per year (Status Quo) to 82.8 (by treating only PWID with fibrosis level <i>F</i>₂ and higher) or to 65.5 (by treating PWID regardless of fibrosis level). If PWID also had access to increased harm-reduction activities, the incidence rate further decreased to 53.1 per 1000 susceptible PWID per year. We also obtained significant decreases in prevalence and mortality at the end of 2030.</p><p>Conclusions</p><p>The combination of increased access to HCV testing, highly efficacious antiviral treatment and harm-reduction programs can substantially decrease the burden of the HCV epidemic among PWID. However, unless we increase the current levels of treatment and testing, the HCV epidemic among PWID in BC, and in other parts of the world with similar epidemiological background, will remain a substantial public health concern for many years.</p></div

HCV Transmission and Disease Progression Model Schematic.

<p>HCV Transmission and Disease Progression Model Schematic.</p

Percent change in (A) HCV incidence rate, (B) HCV prevalence and (C) mortality, at the end of 2030, for different testing and treatment scale-up scenarios.

<p>Blue bars: assume that 140 per 1000 PWIDs are tested and that 8, 20, 40 and 80 per 1000 PWID are treated for HCV per year; treatment eligibility applies only to the chronic aware population (<i>C</i>_<i>a</i>) with fibrosis level <i>F</i>₂ and higher. Green bars: assume that 140 per 1000 PWIDs are tested and that 8, 20, 40 and 80 per 1000 PWID are treated for HCV per year; treatment eligibility applies only to the chronic aware population (<i>C</i>_<i>a</i>) with fibrosis level <i>F</i>₀ and higher. Gold bars: assume that PWIDs are tested immediately upon ending the acute phase and that 8, 20, 40 and 80 per 1000 PWID are treated for HCV per year; treatment eligibility applies both to the chronic unaware (<i>C</i>_<i>u</i>) and aware (<i>C</i>_<i>a</i>) population with fibrosis level <i>F</i>₀ and higher. Note that in this case PWID do not spend time in the <i>C</i>_<i>u</i> compartment and go straight to the <i>C</i>_<i>a</i> compartment due to the testing intervention.</p

Reported and predicted percentage reductions in patient outcomes between intervention and control sites among cluster randomized controlled trials to assess indirect patient benefits from increased influenza vaccine coverage of healthcare workers in long-term care facilities.

<p>Reported and predicted percentage reductions in patient outcomes between intervention and control sites among cluster randomized controlled trials to assess indirect patient benefits from increased influenza vaccine coverage of healthcare workers in long-term care facilities.</p