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Women and children in the developing world will continue to die from sexually transmitted infections (STIs) at current rates unless rapid tests meeting stringent criteria become available for screening within a treatment and prevention programme, under a World Health Organisation (WHO) initiative.
Ultimately the aim is to develop an essential diagnostics package comprising rapid tests for HIV, tuberculosis, malaria, and STIs—like the WHO Essential Medicines package for developing countries.
The strategy has been to give priority to tests that are ASSURED—affordable, sensitive, specific, user friendly, robust and rapid, equipment free, and deliverable to those in need. Tests for syphilis that increase access to screening have been selected and tests for gonorrhoea and genital chlamydia for screening high risk populations and for increasing specificity of treating infections according to syndrome.
In time ASSURED tests might have a similar impact to rapid tests for HIV, now routine in voluntary counselling and testing centres and antenatal clinics worldwide. Under the initiative a 10 point plan to achieve this ranges from searching for more ASSURED tests through to a pilot road map for introducing them, to establishing quality assurance testing locally and nationally to maintain test performance, as well as assessing the role of rapid diagnostics for viral STIs and achieving consensus on tests to use to help manage vaginal discharge and genital chlamydia and gonococcal infections.
Meeting goals set in 2000 to curb mortality among children aged under 5 years by 75% in 2015 depends on these measures to improve access to quality assured tests in prenatal care and for suspect populations.
Peeling RW, et al. Sexually Transmitted Infections 2006;82(Suppl V):v1–v6.
Please visit the Journal of Clinical Pathology website [www. jclinpath.com] for a link to the full text of this article.