scholarly journals Syndromic versus Laboratory Diagnosis of Sexually Transmitted Infections in Men in Moshi District of Tanzania

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Yuwei Cheng ◽  
Elijah Paintsil ◽  
Musie Ghebremichael
Keyword(s):  
Sexually Transmitted Infections ◽  
Laboratory Testing ◽  
High Specificity ◽  
Cost Effective ◽  
Laboratory Diagnosis ◽  
Receiver Operating Curve ◽  
Sexually Transmitted ◽  
Resource Limited ◽  
Syndromic Diagnosis ◽  
Low Sensitivity

The syndromic diagnosis of sexually transmitted infections (STIs) is widely recognized as the most practical, feasible, and cost-effective diagnostic tool in resource-limited settings. This study assessed the diagnostic accuracy of syndromic versus laboratory testing of STIs among 794 men randomly selected from the Moshi district of Tanzania. Participants were interviewed with a questionnaire that included questions on history of STIs symptoms. Blood and urine samples were taken from the participants for laboratory testing. Only 7.9% of the men reported any symptoms of STI; however, 46% of them tested positive for at least one STI. There was little agreement between syndromic and laboratory-confirmed diagnoses, with low sensitivity (0.4%–7.4%) and high specificity (96%–100%) observed for each individual symptom. The area under the receiver-operating curve was 0.528 (95% CI: 0.505–0.550), indicating that the syndromic approach has a 52.8% probability of correctly identifying STIs in study participants. In conclusion, whenever possible, laboratory diagnosis of STI should be favored over syndromic diagnosis.

scholarly journals The Syndromic versus Laboratory Diagnosis of Sexually Transmitted Infections in Resource-Limited Settings

ISRN AIDS ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Musie Ghebremichael
Keyword(s):  
Sexually Transmitted Infections ◽  
High Specificity ◽  
Laboratory Diagnosis ◽  
Sub Saharan Africa ◽  
Resource Limited Settings ◽  
Sexually Transmitted ◽  
Resource Limited ◽  
Patient Reported ◽  
Syndromic Diagnosis ◽  
Sub Saharan

Sexually transmitted infections (STIs) are highly prevalent in sub-Saharan Africa, where there is a severe HIV epidemic. Thus, accurate recognition and diagnosis of STIs are essential for successful HIV prevention programs in the region. Due to lack of trained personnel and adequate laboratory infrastructure in the region, information regarding the profile of STIs relies essentially on self-reported or physician-diagnosed symptoms. The main objective of the study was to assess the effectiveness of the syndromic diagnosis of STIs, which is often used as a proxy for laboratory diagnosis of STIs in sub-Saharan Africa and other resource-limited settings. The study builds on previously collected data from a community-based survey in Northern Tanzania. We found no significant agreements between patient-reported STIs symptoms and laboratory-confirmed STIs tests. The reported STIs symptoms had high specificity (range = 85–99%) and poor sensitivity (range = 2–17%). Knowledge gained from our study will have significant public health implications, and can help improve the syndromic diagnosis of STIs.

scholarly journals Current and Future Trends in the Laboratory Diagnosis of Sexually Transmitted Infections

2021 ◽  
Vol 18 (3) ◽  
pp. 1038
Author(s):  
Giorgia Caruso ◽  
Anna Giammanco ◽  
Roberta Virruso ◽  
Teresa Fasciana
Keyword(s):  
Sexually Transmitted Infections ◽  
Point Of Care ◽  
Risk Groups ◽  
Laboratory Diagnosis ◽  
Diagnostic Tools ◽  
Sexually Transmitted ◽  
Social Burden ◽  
High Prevalence ◽  
Syndromic Diagnosis ◽  
Asymptomatic Infections

Sexually transmitted infections (STIs) continue to exert a considerable public health and social burden globally, particularly for developing countries. Due to the high prevalence of asymptomatic infections and the limitations of symptom-based (syndromic) diagnosis, confirmation of infection using laboratory tools is essential to choose the most appropriate course of treatment and to screen at-risk groups. Numerous laboratory tests and platforms have been developed for gonorrhea, chlamydia, syphilis, trichomoniasis, genital mycoplasmas, herpesviruses, and human papillomavirus. Point-of-care testing is now a possibility, and microfluidic and high-throughput omics technologies promise to revolutionize the diagnosis of STIs. The scope of this paper is to provide an updated overview of the current laboratory diagnostic tools for these infections, highlighting their advantages, limitations, and point-of-care adaptability. The diagnostic applicability of the latest molecular and biochemical approaches is also discussed.

Laboratory Diagnosis of Sexually Transmitted Infections

1994 ◽  
Vol 23 (7) ◽  
pp. 361-369 ◽  
Author(s):  
Franklyn N Judson ◽  
Josephine Ehret
Keyword(s):  
Sexually Transmitted Infections ◽  
Laboratory Diagnosis ◽  
Sexually Transmitted

scholarly journals Evaluation of Modified Two-Tiered Testing Algorithms for Lyme Disease Laboratory Diagnosis Using Well-Characterized Serum Samples

2018 ◽  
Vol 56 (8) ◽  
Author(s):  
Adoracion Pegalajar-Jurado ◽  
Martin E. Schriefer ◽  
Ryan J. Welch ◽  
Marc R. Couturier ◽  
Tiffany MacKenzie ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Laboratory Testing ◽  
Laboratory Diagnosis ◽  
Serum Samples ◽  
Chemiluminescence Immunoassay ◽  
Testing Algorithms ◽  
Second Tier ◽  
Testing Algorithm ◽  
Low Sensitivity ◽  
Recommended Algorithm

ABSTRACTStandard two-tiered testing (STTT) is the recommended algorithm for laboratory diagnosis of Lyme disease (LD). Several limitations are associated with STTT that include low sensitivity in the early stages of disease, as well as technical complexity and subjectivity associated with second-tier immunoblotting; therefore, modified two-tiered testing (MTTT) algorithms that utilize two sequential first-tier tests and eliminate immunoblotting have been evaluated. Recently, a novel MTTT that uses a VlsE chemiluminescence immunoassay followed by a C6 enzyme immunoassay has been proposed. The purpose of this study was to evaluate the performance of the VlsE/C6 MTTT using well-characterized serum samples. Serum samples from the CDC Lyme Serum Repository were tested using three MTTTs, VlsE/C6, whole-cell sonicate (WCS)/C6, and WCS/VlsE, and three STTTs (immunoblotting preceded by three different first-tier assays: VlsE, C6, and WCS). Significant differences were not observed between the results of the MTTTs assessed; however, the VlsE/C6 MTTT resulted in the highest specificity (100%) when other diseases were tested and the lowest sensitivity (75%) for LD samples. Significant differences were present between the results for various MTTTs and STTTs evaluated. Specifically, all MTTTs resulted in higher sensitivities than the STTTs for all LD groups combined and were significantly more accurate (i.e., higher proportion of correct classifications) for this group, with the exception of the WCS/ViraStripe STTT. Additionally, when other diseases were tested, only the results of the VlsE/C6 MTTT differed significantly from those of the WCS/ViraStripe STTT, with the VlsE/C6 MTTT resulting in a 6.2% higher accuracy. Overall, the VlsE/C6 MTTT offers an additional laboratory testing algorithm for LD with equivalent or enhanced performance compared to that of the other MTTTs and STTTs evaluated in this study.

Diagnosis of sexually transmitted infections (STI) using self-collected non-invasive specimens

Sexual Health ◽  
2004 ◽  
Vol 1 (2) ◽  
pp. 121 ◽  
Author(s):  
Suzanne M. Garland ◽  
Sepehr N. Tabrizi
Keyword(s):  
Sexually Transmitted Infections ◽  
Control Strategies ◽  
Cost Effective ◽  
Diagnostic Techniques ◽  
Detection Methods ◽  
Molecular Diagnostic ◽  
Molecular Diagnostic Techniques ◽  
Sexually Transmitted ◽  
Diagnostic Assays ◽  
Remote Areas

Paramount in control of transmission of sexually transmitted infections (STIs) is their prompt recognition and appropriate treatment. In countries where definitive diagnoses are difficult, a ‘syndromic approach’ to management of STIs is recommended and practiced, yet many STIs have common symptoms or are asymptomatic and therefore go undetected and untreated. This is of particular concern with the recognition that HIV transmission is increased with co-existent STIs: the attributable risk for each STI varying with the prevalence within a particular population. Hence, HIV public health prevention approaches must include STI preventative strategies to be effective. Even then, microbiological screening is incorporated into STI control strategies; lack of access to appropriate services (especially in rural and remote areas), reluctance of at-risk populations to attend for treatment, fear of invasive genital examinations, and lower sensitivities of conventional diagnostic assays reduces the effectiveness of such programmes. Therefore, accurate, cost-effective, reliable diagnostic assays (preferably those which can be used in the field) are needed to impact on the incidence of the various STIs, as well as HIV. With the advent of molecular technologies, including target and signal amplification methods, diagnoses of STIs have been revolutionised and allow the use of non or minimally invasive sampling techniques, some of which are self-collected by the patient, e.g. first-void urine, cervico-vaginal lavage, low vaginal swabs, and tampons. Most studies evaluating such self-sampling with molecular diagnostic techniques have demonstrated an equivalent or superior detection of STIs as compared to conventional sampling and detection methods. These sampling methods can also be used to determine prevalence of STIs in various populations, but particularly those with difficult access to medical care. In this article, the utility of self-sampling collection devices for detection of various STIs, particularly in women, is reviewed as one step towards formulating appropriate strategies in control of STIs, and which are especially suited for remote areas.

scholarly journals Rapid tests in the diagnostics of sexually transmitted infections

2015 ◽  
Vol 64 (1) ◽  
pp. 34-43
Author(s):  
Olga Sergeyevna Ryzhkova
Keyword(s):  
Sexually Transmitted Infections ◽  
Point Of Care ◽  
High Specificity ◽  
Molecular Diagnostic ◽  
Sexually Transmitted ◽  
Highly Sensitive ◽  
High Prevalence ◽  
Microfluidic Biosensor ◽  
Rapid Tests ◽  
Diagnostic Technologies

High prevalence of sexually transmitted infections (STIs) and their substantial adverse effect on reproductive health of people necessitate the development of accurate and rapid tests for their diagnostics, in particular those that can be used at point-of-care (POC). The majority of current immunological POC-tests have high specificity; however, their sensitivity is mainly suboptimal. The future of POC-diagnostics of STIs - highly sensitive and specific, robust and affordable - is seen in the development and implementation of molecular diagnostic technologies (amplification, microfluidic, biosensor).

scholarly journals How do we diagnose immune thrombocytopenia in 2018?

Hematology ◽  
2018 ◽  
Vol 2018 (1) ◽  
pp. 561-567 ◽  
Author(s):  
John G. Kelton ◽  
John R. Vrbensky ◽  
Donald M. Arnold
Keyword(s):  
Immune Thrombocytopenia ◽  
High Specificity ◽  
Laboratory Diagnosis ◽  
Test Methods ◽  
Considerable Variability ◽  
Clinical Expression ◽  
Current Test ◽  
Underlying Mechanisms ◽  
Low Sensitivity ◽  
The Ideal

Abstract In this report, we will review the various clinical and laboratory approaches to diagnosing immune thrombocytopenia (ITP), with a focus on its laboratory diagnosis. We will also summarize the results from a number of laboratories that have applied techniques to detect anti-platelet autoantibodies as diagnostic tests for ITP. Although there is considerable variability in methods among laboratories, there is general agreement that platelet autoantibody testing has a high specificity but low sensitivity. This suggests several possibilities: (1) the ideal test for ITP has yet to be developed, (2) current test methods need to be improved, or (3) ITP is the clinical expression of a variety of thrombocytopenic disorders with different underlying mechanisms. Even the clinical diagnosis of ITP is complex, and experienced clinicians do not always agree on whether a particular patient has ITP. Improvements in the diagnostic approach to ITP are necessary to improve the management of this disorder.

Sexually transmitted infections screening at HIV treatment centers for MSM can be cost-effective

AIDS ◽  
2013 ◽  
Vol 27 (14) ◽  
pp. 2281-2290 ◽  
Author(s):  
Henrike J. Vriend ◽  
Anna K. Lugnér ◽  
Maria Xiridou ◽  
Maarten F. Schim van der Loeff ◽  
Maria Prins ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Cost Effective ◽  
Hiv Treatment ◽  
Sexually Transmitted

scholarly journals The ABCs of STIs: An Update on Sexually Transmitted Infections

2016 ◽  
Vol 62 (6) ◽  
pp. 811-823 ◽  
Author(s):  
Melanie L Yarbrough ◽  
Carey-Ann D Burnham
Keyword(s):  
Sexually Transmitted Infections ◽  
Disease Transmission ◽  
Laboratory Testing ◽  
Diagnostic Methods ◽  
Sexually Transmitted ◽  
Therapeutic Guidelines ◽  
Immunodeficiency Virus ◽  
The Us ◽  
Appropriate Therapy ◽  
Changing Practices

Abstract BACKGROUND Sexually transmitted infections (STIs) are spread primarily through sexual contact and are a major cause of morbidity and mortality worldwide. Once identified, some STIs can be cured following appropriate therapy; for others, suppressive regimens and approaches to prevent ongoing transmission are important. The incidence of many common STIs is increasing in the US as well as worldwide, and hundreds of millions of people are currently infected. Laboratory testing plays a major role in the diagnosis and treatment of STIs, and clinical laboratorians should be familiar with the current guidelines and methods for testing. CONTENT Accurate and sensitive methods to diagnose STIs are essential to direct appropriate antimicrobial therapy and interrupt the cycle of disease transmission. This review summarizes laboratory testing for common bacterial, viral, and parasitic causes of STIs. Disease manifestations reviewed include cervicitis and urethritis, genital ulcerative disease, human immunodeficiency virus, viral hepatitis, human papilloma virus, and vaginitis. Recent advancements in the recognition and management of STIs, including updates to diagnostic algorithms, advances in testing methods, and emerging challenges with antimicrobial resistance, are summarized. SUMMARY Diagnostic methods and therapeutic guidelines for STIs are rapidly evolving. In combination with changing epidemiology, the development of novel therapeutics, and advancements in diagnostic methods, this has resulted in changing practices in laboratory testing and, subsequently, management of disease. Molecular methods have facilitated personalized therapy and follow-up regimens targeted for individual types or strains of some STIs.

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