Evaluating Point-of-Care Testing in Rural Communities: Impact of Reduced Turnaround Time on Outcomes for Respiratory Infections, Group A Streptococci and Sexually Transmitted Infections.

Point of care testing (PoCT) for Group A Streptococcus (GAS), respiratory infections, and sexually transmitted infections (STIs) for rural communities at eight primary care sites in Aotearoa New Zealand -Provision of PoCT diagnostic machines to two sites, one site has their own PoCT machines -Training of nursing and health work staff in the set-up, running, preparing samples, interpreting results, quality assurance procedures, clinical update training -This involves face-to-face hands on training at the research sites 2-3 nurses and or health workers are trained at each site -Training is provided by molecular scientist on the research team and online training from the PoCT manufacturer and a certificate is provided once training is complete. -Training is a 2-4 hour session the week prior to recruitment starting, follow up one hour sessions in person or zoom 3 monthly at each site - includes regular site visits for quality and update purposes - PoCT testing will be undertake ONLY by clinic staff who have undergone training from the molecular scientist on research team and from the PoCT manufacturers official online training - Patients will be consented face to face by the clinic staff as part of their usual clinic appointment - Clinical staff will decide if the patient requires a test depending on presentation and history - Clinical management is not changed from usual standard care, only the diagnostic test is different from usual lab pathway - Patients can have multiple tests within the study recruitment period if clinically indicated - Rural primary care clinics - Patient adherence and fidelity is not indicated in this study as it is clinical staff who make the decision to test -PoCT machines used are Cepheid Gene Xperts at two sites, Roche Liats at one site - PoCT machines are set up in a suitable and appropriate space within the clinic with appropriate biohazard disposal, clean bench space, storage facilities for supplies and access to a fridge, -testing cartridges are provided by the study - technological support provided by research team scientist and PoCT manufacturers as needed. - test running time is from 30-90 minutes depending on infection being tested for - e.g. GAS - 30mins, Chlamydia/NG 90 minutes