Point-of-Care Testing for Sexually Transmitted Infections: A Review of Recent Developments

Abstract

Context.—: Sexually transmitted infections (STIs) are among the most common communicable diseases globally and are associated with significant morbidity and mortality worldwide. Point-of-care tests have the potential to revolutionize the prevention and control of STIs by enabling rapid diagnosis and early treatment of infections, thus interrupting transmission and preventing the sequelae of untreated infections. Currently, there are several point-of-care (POC) tests available for the diagnosis of Treponema pallidum, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis infections, although these tests differ with regard to their performance, turnaround time, and cost.

Objective.—: To provide an updated review of the POC tests available and under development for the diagnosis of T pallidum, C trachomatis, N gonorrhoeae, and T vaginalis infections, to discuss the context for which these tests might be used, and to highlight future directions for test development.

Data sources.—: We reviewed the literature pertaining to the recent development and performance evaluations of POC tests for the diagnosis of syphilis, chlamydia, gonorrhea, and trichomonas.

Conclusions.—: Recently, there has been rapid development of new POC tests for STIs. Although there are inexpensive, rapid, and accurate POC tests available for syphilis, there are few such tests available for the diagnosis of chlamydia, gonorrhea, or trichomonas, and currently none with the ability to detect antimicrobial resistance in N gonorrhoeae. Research evaluating implementation strategies for the currently available tests and the development of additional POC tests that are rapid, accurate, and affordable are urgently needed to address the rising number of STIs worldwide.

Figure 1.

Total number and distribution of new syphilis, gonorrhea, chlamydia, and trichomoniasis infections worldwide in 2016, by World Health Organization Region.

Figure 2.

The GeneXpert system. Images used with permission from Cepheid.

Figure 3.

Point-of-care tests, available and under development, for the diagnosis of syphilis, chlamydia, gonorrhea, and trichomoniasis. Dotted lines indicate tests that are not yet commercially available. Figure adapted from prior report and used with author’s permission. Abbreviations: CT, Chlamydia trachomatis; NG, Neisseria gonorrhoeae; PCR, polymerase chain reaction; TV, Trichomonas vaginalis.