Use of healthcare reimbursement data to monitor bacterial sexually transmitted infection testing in France, 2006 to 2020.

BackgroundDiagnoses of bacterial sexually transmitted infections (STIs) have increased in France since the 2000s. The main strategy to control STI transmission is recommending/facilitating access to condom use, testing, and antibiotic treatments.AimThis study analyses the evolution of STI testing in the private sector in France from 2006 to 2020.MethodsNational health insurance reimbursement data were used to determine numbers and rates of individuals aged ≥ 15 years tested for diagnoses of chlamydia, gonorrhoea and syphilis in the private sector in France and to describe their evolution from 2006 to 2020.ResultsUpward tendencies in testing were observed from 2006 to 2019 for all three STIs. The highest testing rates were identified in people aged 25‒29-years old. The observed testing-increase from 2017 to 2019 was twice as high in young people (< 25 years old) as in older people. In 2019, chlamydia, gonorrhoea and syphilis testing rates were respectively 45.4 (+ 21% since 2017), 41.3 (+ 60%), and 47.2 (+ 22%) per 1,000 inhabitants. For all STIs combined, the number of tested individuals decreased by 37% between March and April 2020 during the first COVID-19 epidemic wave and lockdown in France.ConclusionImprovements found in STI testing rates may have resulted from better awareness, especially among young people and health professionals, of the importance of testing, following prevention campaigns. Nevertheless, testing levels remain insufficient considering increasing diagnoses. In 2020, the COVID-19 pandemic had a considerable impact on STI testing. Partner notification and offering diverse testing opportunities including self-sampling are essential to control STI epidemics particularly in exposed populations.

SARS-CoV-2 and post-donation information: a one-year experience of the French haemovigilance network.

BACKGROUND: There is growing evidence to support the hypothesis that SARS-CoV-2 is probably not transmissible by blood transfusion. In this study, we use the data gathered over one year by the French haemovigilance network on post-donation information related to SARS-CoV-2, and virological investigations on corresponding plasma to explore viral transmission by transfusion. MATERIALS AND METHODS: Whenever a donor reported COVID-19 symptoms and/or a positive SARS-CoV-2 nasopharyngeal (NP) PCR test, information regarding diagnosis and symptoms was collected using a specific questionnaire, and repository plasmas were screened using the SARS-COV-2 R-GENE® assay (Biomérieux). RNA sequencing (Sanger and deep sequencing) and virus isolation on Vero E6 cells were applied in plasma from donors testing positive. RESULTS: We investigated 1,092 SARS-CoV-2-related post-donation information (PDI) reports. PDI donors were younger than the global donor population and donated more often in the Paris region. Sixty-eight percent reported a positive NP real-time (RT)-PCR or antigenic testing and 22% of these also had symptoms at the time of testing. Thirty-seven (3.4%) donations tested positive for SARS-CoV-2 RNA, 11 (30%) were confirmed by another molecular assay, and 7 (19%) by sequencing, confirming low viral level. Most RNAemic blood donors donated in southern regions and in Paris. There was no difference in demographic data or duration parameter between RNAemic and non-RNAemic donors. Duration parameter was determined as the time elapsed between donation and: i) the onset of symptoms; ii) a positive NP RT-PCR; and iii) PDI. Cell culture experiments did not show any infectivity related to RNAemic plasmas. DISCUSSION: SARS-CoV-2 RNA can be detected in a small fraction of blood donors with PDI, reporting very low levels of RNA. The corresponding plasma is probably not infectious. These findings highlight the value of haemovigilance and PDI to guide blood safety strategies.

DGVRetroDon : contribution à l'évaluation du risque de transmission du SARS-CoV-2 par transfusion par un dépistage de l'ARN viral plasmatique dans des dons de sang en France

Lors de l'émergence de l'épidémie de SARS-CoV-2, la question d'une possible transmission par transfusion du virus a été évoquée avec la mise en évidence d'ARN dans le plasma de donneurs de sang. Une étude rétrospective a été réalisée à partir d'échantillons de biothèque transfusionnelle issus de dons de sang prélevés au pic épidémique en France (du 23 au 28 mars 2020), dans les régions les plus impactées (NORD et EST). Selon plusieurs hypothèses de prévalence, la taille d'échantillon minimale a été estimée à 6000. Le dépistage a été réalisé sur des pools de 4 échantillons (P4) par une méthode automatisée (Procleix SARS-CoV-2, Panther System, Grifols). 9672 échantillons ont été testés sous la forme de 2418 pools (P4). Cinq pools ont été dépistés positifs. Sur les 20 échantillons unitaires composant ces pools expertisés au CNR RIT (INTS), 1 seul a été confirmé par 2 méthodes différentes de RT-PCR, avec de faibles intensités réactionnelles suggérant une très faible charge virale. La mise en culture du plasma correspondant n'a pas permis d'isoler le virus. Cet échantillon provenait d'une donneuse ayant décrit rétrospectivement des symptômes évocateurs de COVID-19 dans les jours suivant son don (sans avoir été testée). Aucun EIR n'a été mis en évidence lors de l'enquête d'hémovigilance réalisée chez les receveurs du CGR et du MCP issus du don ARN SARS-CoV-2 positif. Cette étude confirme la possible présence d'ARN du virus SARS-CoV-2 dans le plasma de donneurs de sang asymptomatiques, à taux très faible, avec une prévalence d'environ 1/10 000 dons en période épidémique, sans que le caractère infectieux n'ait été démontré. (French) [ABSTRACT FROM AUTHOR] Copyright of Transfusion Clinique et Biologique is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)