Accurate, rapid, point-of-care tests for sexually transmitted infections

WHO estimates that more than 376 million new sexually transmitted infection (STI) cases each year are caused by Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Treponema pallidum, 1 and Mycoplasma genitalium infections are also prevalent globally. 2 Accurate and timely STI diagnosis and treatment are imperative to prevent the transmission and complications or sequelae (eg, infertility, ectopic pregnancy, and stillbirth) of untreated infections. However, in many under-resourced settings with highest STI burdens, 1 only syndromic STI case management is available due to a lack of laboratory diagnostics or funding. The accuracy of diagnosis based on vaginal discharge and anorectal syndromes is low for C trachomatis, N gonorrhoeae, and M genitalium, and asymptomatic infections are uncaptured. 3 This low accuracy can result in missed treatment, incorrect treatment, and overtreatment, which cause further STI spread and antimicrobial resistance in STI organisms, other infectious agents, and bystander microbes. 3 Additionally, in many well-resourced settings, because of delays in receiving diagnostic results from recommended laboratory-based nucleic acid amplification tests (NAATs) and the potential loss of patients for treatment, many patients are treated with empirical recommended treatment before laboratory diagnostic results are available. Furthermore, the treatment of gonorrhoea and M genitalium infections is severely compromised by antimicrobial resistance worldwide. 4 ,  5 Accordingly, rapid, sensitive, specific, and affordable point-of-care tests for timely diagnosis and accurate treatment of STIs are urgently needed, both in low-resource and high-resource settings.

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