Rapid tests for sexually transmitted infections (STIs): the way forward
Rapid tests for sexually transmitted infections (STIs): the way forward
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DOI：
10.1136/sti.2006.024265
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发表时间：
2006-12-01
影响因子：
3.6
通讯作者：
Ronald, A.
中科院分区：
文献类型：
--
作者：
Peeling, R. W.;Holmes, K. K.;Ronald, A.
在发展中国家，性传播感染的实验室服务要么无法提供，要么在服务有限的地方，患者可能无法支付或实际获得这些服务。尽管存在预防先天性梅毒的产前筛查国家政策，并且有大量证据表明产前筛查具有成本效益，但由于缺乏可在初级卫生保健环境中使用的筛查工具，梅毒筛查规划的执行程度仍然低得令人无法接受。世界卫生组织性传播疾病诊断行动（SDI）制定了ASSURED标准，作为确定检测是否满足疾病控制需求的基准：价格合理、敏感、特异性、用户友好、快速和可靠、无需设备和可向最终用户交付。可用于全血的快速梅毒检测方法接近ASSURED标准，现在可用于以前无法进行筛查的地区。尽管衣原体和淋病的快速检测缺乏敏感性，但更多的检测正在开发中。性传播感染诊断的前进道路需要继续寻求有保证的检测，制定采用检测的路线图，可持续的质量保证规划，以及建立与艾滋病毒预防相关的强大基础设施，确保包括病毒性性传播感染在内的性传播感染控制工作的可持续性。
In the developing world, laboratory services for sexually transmitted infections (STIs) are either not available, or where limited services are available, patients may not be able to pay for or physically access those services. Despite the existence of national policy for antenatal screening to prevent congenital syphilis and substantial evidence that antenatal screening is cost-effective, implementation of syphilis screening programmes remains unacceptably low because of lack of screening tools that can be used in primary health care settings. The World Health Organization Sexually Transmitted Diseases Diagnostics Initiative ( SDI) has developed the ASSURED criteria as a benchmark to decide if tests address disease control needs: Affordable, Sensitive, Specific, User- friendly, Rapid and robust, Equipment-free and Deliverable to end-users. Rapid syphilis tests that can be used with whole blood approach the ASSURED criteria and can now be deployed in areas where no previous screening has been possible. Although rapid tests for chlamydia and gonorrhoea lack sensitivity, more tests are in development. The way forward for STI diagnostics requires a continuing quest for ASSURED tests, the development of a road map for test introduction, sustainable programmes for quality assurance, and the creation of a robust infrastructure linked to HIV prevention that ensures sustainability of STI control efforts that includes viral STIs.