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Epidemiology poster session 1: STI trends
P1-S1.03 Undiscovered burden of STIs in Russia: current system shortcomings
  1. N Anisimova1,
  2. T Ivanova1,
  3. A Guschin1,
  4. E Simonova1,
  5. A Zakharova2,
  6. O Novoschilova2,
  7. V Shakhzadov2,
  8. A Shevchenko2
  1. 1Central Research Institute for Epidemiology, Moscow, Russian Federation
  2. 2Skin and Veneral Disease Clinic, Russian Federation

Abstract

Background At the moment the major source of statistical data on STIs in Russia is the system of dermatovenerologic clinics (DVC). In accordance with Russian legislation DVCs perform periodic screening of economically active population for asymptomatic STIs disclosure and recording. We need to underline that microscopy for Trichomonas vaginalis and Neisseria gonorrhoeae is the only method involved in this screening. PCR is not approved for the program which means that there is no control over Chlamydia trachomatis burden. Thereby, this study was set to evaluate the screening efficacy in terms of one DVC in Moscow, Russia.

Methods This study included asymptomatic women aged 16–45 invited for periodic screening. In the DVC Gram stained smear microscopy for TV and GC was used in accordance with regulatory documents. In addition to the standard process a swab for multiplex PCR analysis (GC/CT/TV/MG) was obtained from each participant. All positive results were confirmed with monoplex PCR assays.

Results According to the official statistical report the overall quantity of people screened in this particular DVC throughout the year 2010 was 16 231. In this study samples from 1125 (6.95%) of them were examined. PCR detected 20 (1.78%) CT cases; 20 (1.78%) MG; 13 (1.16%) TV; 3 (0.27%) GC, whereas microscopy showed no TV or GC positive results. That means that screening revealed no STIs in this group at all. The study showed that the majority of women screened were aged 35–44 (44.2%), p<0.05, whereby the maximum prevalence of CT was observed among 20–34-years-old women (3.5%), p<0.001, MG among 25–34-years-old women (3.3%), p<0.001. We registered no significant TV or GC prevalence distribution among the age groups. It is important to note that the overall STI burden reported by this DVC for 2010 comprised of 9 (0.05%) TV positive cases, no GC was detected among 16 231 persons screened. The data observed in this study allows us to suggest that PCR could reveal the following amounts of STIs in this group—Ct-288 (95% CI 159 to 418); Mg-288 (95% CI 159 to 418); Tv-187 (95% CI 90 to 285); Ng-43 (95% CI 0 to 92).

Conclusions The data obtained shows the inefficacy of the routine STI screening in Russia. Low sensitivity diagnostic tools prevent us from revealing huge amounts of positive results. At the same time implementation of modern methods with higher sensitivities to the ongoing system will lead to more effective STI uncovering, especially in the groups of higher risk.

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