Diag nostics of gonorrhoea in Ukraine following World Health Organization recommendations

Abstract

Objective — to evaluate the compliance of gonorrhoea diagnostics in regional skin and venereological dispensaries (RSVD) in Ukraine during 2013—2014 to World Health Organization (WHO) laboratory recommendations and identify areas for its improvement. Materials and methods. The study analyzed statistics data regarding the number of performed laboratory tests and their positive results for the detection of gonococci, the collection of biological samples and the use of laboratory methods for N. gonorrhoeae identification obtained from 14 RSVD of Ukraine by questionnaire. Results and discussion. Dispensary laboratories performed microscopy, culture and point-of-care-tests in 100, 85.7 and 7.1 % of patients, respectively. Gonococci were found in 2.3 % of the patients, equally by the results of microscopy (1740/76 348) and by culture (1322/56 273). Dispensary laboratories did not perform nucleic acid amplification tests. Sampling of biological material from three anatomical sites (urogenital, pharyngeal and rectal specimens) in heterosexual patients with symptoms of sexually transmitted infection was performed by 25 % of respondents, from two sites (urogenital and pharyngeal) — by 41.7 %, and from one site (urogenital sample) — by 33.3 % of dispensaries. External quality control of laboratory tests for the detection of N. gonorrhoeae was performed by 50 % of the respondents. Non-selective nutrient media for isolation of N. gonorrhoeae was used by 16.7 % of dispensaries, and prepared nutrient media in test tubes instead of the recommended Petri dishes, were used in 58.3 % of dispensaries. The vast majority of respondents (78.6 %) had an experience of determining gonococcal sensitivity to antibiotics. Two institutions (14.3 %) participated in an international pilot project to determine the antibiotic resistance of gonococci. Conclusions. Diagnostics of gonococcal infection in Ukraine is not optimal and needs improvement by using quality-tested bacteriological cultures and point-of-care-tests, implementation of nucleic acid amplification tests, monitoring of gonococcal sensitivity to antibiotics, collection of extragenital biological samples. Adherence to evidence-based international guidelines and adapted national guidelines for the diagnostics of gonorrhoea is an essential factor of the controlling of gonococcal infection.