Background The knowledge about approaches used for diagnosis of STIs in Ukraine is scarce. Aiming to optimise the laboratory diagnosis of STIs and introduce antimicrobial resistance surveillance for Neisseria gonorrhoeae, we aimed to survey the algorithms, methodologies and reagents used, and the laboratory capacities and possibilities in three regions of Ukraine.

Methods Laboratories of three regions of Ukraine, namely Dnepropetrovsk, Ternopil and Zaporoz, were visited and detailed interviews were conducted.

Results The three main dispensaries visited serve both the corresponding region as well as the city needs, and also have their own outpatient clinics. Large number of samples is tested, for example in Dnepropetrovsk and Zaporoz yearly 41,000 and 26,000 samples are tested by culture for gonococci, respectively. The majority of samples are coming from gynaecologists and only 0–0.4% contains gonococci. In contrast, testing 4,000 to 10,000 venereology patients per dispensary and year reveals 4–9% of positive samples in all three regions. PCR equipment is available in Dnepropetrovsk and Zaporoz, however, this is rarely used because of lack of funding from the state. Nevertheless, in the private laboratories PCR is run using variety of reagents. Gonococcal culture is primarily performed using Russian or Ukrainian selective growth media. Chlamydia trachomatis and Trichomonas vaginalis iagnosed using cytochrome staining, direct immunofluorescence nd/or serology. For the diagnosis of syphilis Wasserman reaction is still frequently sed; screening is conducted using non-treponemal microprecipitation test, an analogue o the VDRL test. Laboratory quality management systems are unavailable.

Conclusion Optimization and quality assurance of he laboratory diagnosis of STIs in the three interviewed and visited laboratories is crucial. Both methods for testing, reagents as well as the opulations tested have to be revised and adjusted to international evidence-based standards.