In a recent series of reports released by the European Centre for Disease Prevention and Control (ECDC), a troubling surge in sexually transmitted infections (STIs) across Europe has been brought to light, revealing alarming trends and substantial public health implications. The reports specifically focus on chlamydia, gonorrhoea, and lymphogranuloma venereum (LGV), indicating a dynamic and challenging landscape of STIs across 27 European Union/European Economic Area (EU/EEA) countries.
Understanding Lymphogranuloma Venereum (LGV)
LGV is a sexually transmitted infection caused by Chlamydia trachomatis. The latest ECDC assessment reveals a concerning rise in reported cases, emphasizing the unique challenges posed by LGV due to its potential long-lasting complications. This infection primarily affects the lymphatic system and can result in severe damage if not promptly diagnosed and treated.
Transmission occurs through unprotected sexual contact, encompassing vaginal, anal, or oral intercourse. Initial symptoms may include painless genital ulcers, which often go unnoticed. The hallmark of LGV is the development of swollen and painful lymph nodes in the genital or pelvic region. In advanced cases, abscesses may form in affected lymph nodes, resulting in draining fistulas.
The infection has been more frequently reported among men who have sex with men (MSM), and individuals with HIV may face an elevated risk. Prevention involves consistent condom use, regular testing, and early treatment with antibiotics, such as doxycycline or azithromycin. Timely intervention is crucial for managing the infection, preventing complications, and curbing further transmission.
Decoding Syphilis: A Steady Resurgence
Syphilis, a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum, poses a persistent threat with distinct stages and symptoms. Syphilis progresses from painless sores in the early stage, often in the genitals, anus, or mouth. If untreated, it can advance to the last stage, occurring years later, leading to severe complications such as cardiovascular and neurologic issues.
Across Europe, syphilis has witnessed a steady resurgence, with 25,270 confirmed cases in 2021, posing challenges in surveillance, diagnosis, and treatment. Men who have sex with men (MSM) bear a disproportionate burden, constituting 77% of cases, with one-third of MSM with syphilis being HIV positive. Despite a dip in MSM cases between 2020 and 2021 and a minor upswing in male heterosexual cases, women consistently exhibited low rates of syphilis infections in 2021. To address this public health concern, emphasis is placed on prompt diagnosis through blood tests and early intervention with penicillin, highlighting the importance of safe sex practices, regular STI testing, and open communication with sexual partners for prevention.
The Persistent Challenge of Gonorrhoea
Gonorrhea, a prevalent and infectious sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae, poses a significant challenge across Europe. In 2021 alone, there were 46,728 confirmed cases of gonorrhea, surpassing pre-pandemic levels. This bacterium has the potential to infect the genital tract, rectum, and throat, primarily transmitted through sexual contact, including vaginal, anal, and oral intercourse. One of the concerning aspects of gonorrhea is its often asymptomatic nature, especially in women, necessitating regular STI testing for early detection and prompt treatment.
Symptoms, when present, vary depending on the site of infection, including pain or burning during urination, unusual genital discharge, and, in men, painful or swollen testicles. Untreated gonorrhea can lead to severe complications, such as pelvic inflammatory disease (PID) in women, and increases the risk of contracting and transmitting HIV. The rise in cases across the EU/EEA, with men who have sex with men (MSM) accounting for over half of reported cases, raises concerns about antimicrobial resistance (AMR).
This emphasizes the need for vigilant monitoring and robust response strategies to curb the spread of gonorrhea. Mitigating the impact of gonorrhea requires early diagnosis through regular testing, timely treatment with antibiotics, and the practice of safe sex, open communication with sexual partners, and routine STI screenings.
Chlamydia: A Similar Scenario
Chlamydia, caused by the bacterium Chlamydia trachomatis, is a prevalent sexually transmitted infection (STI) known for its widespread occurrence, particularly among sexually active young adults. Notably, chlamydia often exhibits an asymptomatic nature, especially in women, leading to undetected and untreated infections.
The report on chlamydia reveals a parallel pattern of increases from 2012 to 2019, a decline in 2020 likely due to the pandemic’s impact, and a resurgence in 2021. Young adult heterosexual women continue to exhibit the highest rates of chlamydia, indicating gender disparities in testing that may result in underdiagnosis among men. Testing methods typically involve laboratory analysis of urine samples for men and swabs from the cervix or urethra for women. Treatment commonly involves antibiotics like azithromycin or doxycycline.
Diagnostic Strategies in the Face of Escalating Numbers
As the numbers of reported STIs continue to escalate, understanding the diagnostic strategies becomes crucial. ECDC recommends urgent strengthening of prevention activities, focusing on increased testing, targeted messaging, and tailored interventions for specific risk groups. Social media and dating apps are suggested for prevention campaigns, in addition to traditional approaches.
Antimicrobial Resistance Monitoring: A Critical Imperative
Ongoing monitoring of antimicrobial resistance is highlighted as imperative to inform treatment strategies and address emerging challenges. The reports draw attention to the increasing resistance to specific antibiotics for gonorrhoea, emphasizing the need for a proactive approach.
Collaborative Efforts for a Healthier Future
In conclusion, these reports signal a critical juncture in the battle against STIs in Europe. Collaborative efforts among public health authorities, healthcare providers, and communities are deemed essential to curb the spread of these infections and mitigate their impact on individuals and public health systems. As Europe faces this public health challenge, understanding the diverse diagnostic strategies is crucial for effective intervention and control.
What are the Test Types Used in the Diagnosis of Sexually Transmitted Infections (STIs)?
The diagnosis of STIs involves various testing methods, each tailored to detect specific infections. Common test types include:
- Nucleic Acid Amplification Tests (NAATs): These tests identify the genetic material of the pathogens, providing highly sensitive and specific results. NAATs are commonly used for chlamydia and gonorrhoea.
- Blood Tests:
- Serological Tests: Serological tests, such as the rapid plasma reagin (RPR) and the Treponema pallidum particle agglutination (TPPA) test, are utilized for syphilis diagnosis. Blood tests can also indicate the presence of antibodies to certain STIs.
- Swab Tests:
- Genital, Oral, or Rectal Swabs: Swabs are commonly employed to collect samples from genital, oral, or rectal areas. These samples are then analyzed for the presence of pathogens.
Detection ways of different STIs.
- Genital, Oral, or Rectal Swabs: Swabs are commonly employed to collect samples from genital, oral, or rectal areas. These samples are then analyzed for the presence of pathogens.
- Urine Tests:
- Non-Invasive Detection: Urine samples may be tested for chlamydia and gonorrhoea, providing a non-invasive method of detection.
- Culture Tests:
- Bacterial Growth Identification: Culturing involves growing bacteria from a sample to identify the pathogen. While less common due to longer turnaround times, it is still used for some STIs.
- Rapid Tests:
- Quick Results: Rapid tests provide quick results and are often used for point-of-care testing. They are available for various STIs, offering a timely diagnosis.
- PCR Tests (Polymerase Chain Reaction):
- High Sensitivity: PCR tests amplify and detect DNA, offering high sensitivity. They are widely used for chlamydia and gonorrhoea testing, providing accurate and reliable results.
The choice of test depends on the specific STI suspected, the symptoms presented, and the testing facility’s capabilities. Healthcare professionals consider factors such as sensitivity, specificity, and turnaround time to determine the most appropriate test for each case. Regular and widespread testing, using a combination of these methods, plays a crucial role in early detection, effective treatment, and the prevention of further transmission of STIs.
Which Test Kits Are Used to Diagnose of Sexually Transmitted Infections (STIs)?
The Chlamydia Rapid Test is a device specifically designed for the qualitative detection of Chlamydia trachomatis antigen from swab samples. Its advantages include a sterile and safe procedure, providing results in minutes. Users can expect a satisfactory experience with the added benefit of high usability.
The Gonorrhea Rapid Test Kit is specifically crafted for the qualitative detection of Neisseria gonorrhoeae antigens in genital swabs or urine samples. This test kit offers several advantages, including its utility for early detection, which is crucial for timely treatment. With two available test procedures for both genital swab and urine samples, the kit facilitates easy sample collection. Boasting high sensitivity and accuracy, the results are ready within minutes, providing a rapid and efficient diagnostic solution for the detection of Gonorrhea.
The Anti-Syphilis Rapid Test Kit is a user-friendly point-of-care test designed for qualitative syphilis screening in human serum, plasma, and whole blood samples. Its advantages include facilitating early detection and immediate treatment, preventing the transmission of the infection, and hindering the emergence of long-term complications and unfavorable outcomes in pregnancy. The kit features easy sampling and a straightforward procedure, culminating in easily readable results. This makes it a valuable tool for efficient and timely syphilis screening, contributing to proactive medical interventions and preventive measures.
The CHAINFOR™ Vaginosis Id-30 Genotyping qPCR Kits provide a comprehensive in vitro diagnostic solution for the qualitative detection of Vaginosis nucleic acids. These ready-to-use kits, designed for samples from the Throat, Vaginal, Urethral, Urogenital, and Endocervical areas, feature 30 targets in 8 tube reactions. Utilizing a pathogen-based genotyping approach, the kits boast high sensitivity and specificity (>97%) for accurate detection within a rapid and efficient process, delivering results in less than 70 minutes. With a focus on bacterial agents like Neisseria gonorrhoeae, Treponema pallidum, and Chlamydia trachomatis, these kits streamline the diagnosis of Vaginosis nucleic acids, ensuring a reliable and efficient diagnostic experience.
The CHAINFOR™ STI Id-13 Genotyping qPCR Kits are designed for in vitro qualitative diagnosis of STI PATHOGENS nucleic acids in samples from the Throat, Vaginal, Urethral, Urogenital, and Endocervical regions. This ready-to-use kit features 13 targets in a 4-tube reaction, utilizing a pathogen-based genotyping approach with multiplex reaction-based procedures. Specifically targeting bacterial agents such as Neisseria gonorrhoeae, Treponema pallidum, and Chlamydia trachomatis, the kits ensure a comprehensive and efficient STI diagnosis. With simple, rapid, and accurate detection, along with high sensitivity providing results in less than 70 minutes, these kits offer an effective solution for early detection and precise identification of STI pathogens.
REFERENCES
European Centre for Disease Prevention and Control (ECDC). Introduction to the Annual Epidemiological Report. Stockholm: ECDC; 2021. Available at: https://www.ecdc.europa.eu/en/surveillance-and-diseasedata/annual-epidemiological-reports/introduction-annual
European Centre for Disease Prevention and Control (ECDC). Introduction to the Annual Epidemiological Report. Stockholm: ECDC; 2021. Available from: http://ecdc.europa.eu/annual-epidemiological-reports/methods.
European Centre for Disease Prevention and Control (ECDC). Facts about syphilis. Stockholm: ECDC. Available at: https://www.ecdc.europa.eu/en/syphilis/facts
European Centre for Disease Prevention and Control (ECDC). Introduction to the Annual Epidemiological Report. Stockholm: ECDC; 2021. Available at: https://www.ecdc.europa.eu/en/surveillance-and-disease-data/annualepidemiological-reports/introduction-annual
European Centre for Disease Prevention and Control (ECDC). Rising rates of sexually transmitted infections across Europe. Stockholm: ECDC; 2023. Available at: https://www.ecdc.europa.eu/en/news-events/rising-rates-sexually-transmitted-infections-across-europe
Health matters: Preventing stis. GOV.UK. https://www.gov.uk/government/publications/health-matters-preventing-stis/health-matters-preventing-stis
Sexually transmitted infections treatment guidelines, 2021. https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf
