Table of Contents
They are simple and can be used even in remote areas as long as the necessary medicines are available. Equally important, syndromic management of these problems prevents new infections by providing curative treatment without delay and breaking the chain of infection. The syndromic approach to lower abdominal pain in women is widely used, even in developed countries.
Gonorrhoea and chlamydia are among the important causes of lower abdominal pain in women. This approach is designed to offer effective treatment to women with symptoms that could indicate pelvic inflammatory disease. Health care providers should realize that some women managed with this algorithm might not actually have PID false positives.
Vaginal infection bacterial vaginosis, trichomoniasis or yeast infection is the main cause of vaginal discharge. Vaginal discharge algorithms are not designed to detect the more serious and often asymptomatic cervical infections. At present, accurate detection of gonococcal and chlamydial cervicitis requires expensive laboratory tests, which are not available in most settings see Chapter 3 for advice on detecting cervical infections. In some special situations, treatment for cervical infection is justified. Sexually transmitted and other reproductive tract infections A guide to essential practice.
Table 8. What can be done about RTIs? Disinfection and universal precautions Preventing infection in clinical settings High-level disinfection: three steps Universal precautions Annex 3. One of the key questions identified was whether the use of POC diagnostic tests with lower sensitivity is acceptable for use. Such tests may be acceptable for use in certain settings where patients are not routinely tested or treated for STIs.
Adolescents and Young Adults | Prevention | STDs | CDC
In other words, there is a need to balance the sensitivity of POC tests with overall access to care. In addition to an expansion of existing tests that perform well, exciting new methods of pathogen detection were discussed. The ability to miniaturize tests, multiplexing technologies, and paper-based detection methods to reduce costs are all promising approaches. In regards to nanotechnology, use of nanochords or particles to amplify signals is promising development for POC STI diagnostics. Nanotechnology could therefore be used to make the detection of STIs better, faster, and easier.
A barrier to POC test development is how the current regulatory environment often makes it difficult to bring dual and multiplex diagnostic tests into practice. An additional challenge is in the regulation of multiplexed tests, where FDA requirements for analytical and clinical performance may be too stringent and insurmountable. Although making tests too inexpensive could deincentivize production, higher costs could limit adoption of such tests in developing countries.
In summary, although there is a clear and urgent need for rapid POC diagnostics for STIs, the field is in its very early stages. There are exciting new developments in diagnostic technology, but limited demand and challenges in the regulatory approval of such devices exist. Funders and developers will need vision and steady motivation to bring new diagnostics forward.
A problem-based approach
Your Name: optional. Your Email:. Colleague's Email:. Separate multiple e-mails with a ;. Thought you might appreciate this item s I saw at Sexually Transmitted Diseases. Send a copy to your email. Some error has occurred while processing your request. Please try after some time. Conflict of interest: None declared. Received for publication October 10, , and accepted November 21, Back to Top Article Outline. National Institutes of Health. Cited Here World Health Organization. CDC and World Bank.
- Fierce Family.
- Final Recommendation Statement.
- Table of Contents.
Sexually Transmitted Infections in Developing Countries. High rates of chlamydia found among to year-olds attending a rural sexual health clinic: Implications for practice. Sex Health ; — Pediatr Infect Dis J ; — LeFevre ML. Screening for chlamydia and gonorrhea: U.
Preventive Services Task Force recommendation statement. Ann Intern Med ; — Untreated maternal syphilis and adverse outcomes of pregnancy: A systematic review and meta-analysis. Bull World Health Organ ; — PubMed CrossRef. Global epidemiology and control of Trichomonas vaginalis. Curr Opin Infect Dis ; — Costs and health consequences of chlamydia management strategies among pregnant women in sub-Saharan Africa.
Sex Transm Infect ; — Are we satisfied with the tools for the diagnosis of gonococcal infection in females? J Chin Med Assoc ; — Prevention and treatment of mother-to-child transmission of syphilis. Sexually transmitted infections among pregnant women attending an antenatal clinic in Fuzhou, China. Sex Transm Dis ; — Antenatal syphilis screening using point-of-care testing in Sub-Saharan African countries: A cost-effectiveness analysis. PLoS Med ; e Hammerschlag MR. Chlamydial and gonococcal infections in infants and children.
Sexually transmitted infection
Clinical Infectious Diseases. Preventing ophthalmia neonatorum. World Health Organization PLoS One ; e Point-of-care testing for sexually transmitted infections: Recent advances and implications for disease control. Are Treponema pallidum specific rapid and point-of-care tests for syphilis accurate enough for screening in resource limited settings? Evidence from a meta-analysis. PLoS One ; 8:e Epub Feb Sex Transm Infect Peeling RW. Diagnostics in a digital age: An opportunity to strengthen health systems and improve health outcomes.
Int Health ; — Diagnostics as essential tools for containing antibacterial resistance. Drug Resist Updat ; — Infect Dis Obstet Gynecol Lateral flow immuno assay: Its strengths, weaknesses, opportunities and threats. A literature survey.
Adolescents and Young Adults
Anal Bioanal Chem ; — Cuba: Defeating mother-to-child transmission of syphilis. Lancet ; Open Forum Infect Dis ; 1:ofu Laboratory evaluation of three rapid diagnostic tests for dual detection of HIV and Treponema pallidum antibodies. J Clin Microbiol ; — Laboratory Evaluation of a dual-path platform assay for rapid point-of-care HIV and syphilis testing. BMC Res Notes ; Shimelis T, Tadesse E. BMJ Open ; 5:e Laboratory evaluation of three dual rapid diagnostic tests for HIV and syphilis in China and Nigeria. Int J Gynaecol Obstet ; S22— Dual rapid lateral flow immunoassay fingerstick wholeblood testing for syphilis and HIV infections is acceptable and accurate, Port-au-Prince, Haiti.
BMC Infect Dis ; Laboratory evaluation of a dual rapid immunodiagnostic test for HIV and syphilis infection. Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies. Lancet Infect Dis ; — Lynn WA, Lightman S. Syphilis and HIV: A dangerous combination.
Maternal syphilis infection is associated with increased risk of mother-to-child transmission of HIV in Malawi. AIDS ; — High HIV and ulcerative sexually transmitted infection incidence estimates among men who have sex with men in Peru: Awaiting for an effective preventive intervention.
Virulent Treponema pallidum , lipoprotein, and synthetic lipopeptides induce CCR5 on human monocytes and enhance their susceptibility to infection by human immunodeficiency virus type 1. J Infect Dis ; — Cost-effectiveness of HIV and syphilis antenatal screening: A modelling study. Simultaneous triple point-of-care testing for HIV, syphilis and hepatitis B virus to prevent mother-to-child transmission in India.
Pant Pai N, Daher J. Multiplexed testing for HIV and related bacterial and viral co-infections. Expert Rev Mol Diagn;— Diagnostic accuracy of rapid tests for sexually transmitted infections in symptomatic women.
Epub Jul 1.
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