The main objective of Esperance Murebwayire's study is to evaluate the performance of syndromic diagnosis of STIs in comparison with laboratory-confirmed STIs in groups at high risk for HIV acquisition. Syndromic diagnosis of STIs is based on the identification of a group of symptoms and signs that characterise a clinical condition; it relies on subjective judgment, cannot detect asymptomatic infections, and may result in overdiagnosis/overtreatment and potential drug resistance. Laboratory diagnosis is the most accurate method of making a diagnosis, although it may be expensive in some settings, it requires sophisticated laboratory facilities and qualified personnel who can perform technically demanding procedures.
This study includes female sex workers who are enrolled for the first time at different public health clinics and key population clinic (KP) at Project San Francisco (PSF) as well, and clients with STIs who attend KP clinic at PSF. At arrival clients are asked questions regarding STIs and demographic characteristics, and then each participant provides blood, urine and self collected vaginal swabs.
Blood samples are collected and examined by using rapid tests for HIV and syphilis, urine and self collected vaginal swabs are examined for Chlamydia and gonorrhea by using a molecular diagnostic assay GeneXpert®CT/NG test kits which detects both pathogens in the same sample, trichomonas and bacterial vaginosis are detected microscopically on self-collected vaginal swabs.
Knowledge gained from the study will have significant public health implications, and can help improve the syndromic diagnosis of STIs and implement laboratory based diagnosis at least in special groups who have a potential risk of spreading the diseases to a large population.