Background The structure of laboratory services differs among different regions of Russia. In order to apply to international standards initially analysis of the organisational structure, methods and methodologies used is necessary. This study reviewed the features of the laboratory diagnosis of STIs in the Tver region, central Russia.
Methods A questionnaire-based survey concerning STI laboratory services in the Tver region was conducted.
Results The Tver region consists of 36 districts, populated by 1.3 million citizens (406,000 in the Tver city). The wast majority of the laboratories are owned by the State, however, a few privately owned laboratories are also present. The State-owned laboratories are divided into peripheral-district branches, most of them run mainly serology of syphilis and microscopy of genital smears. The remaining laboratory diagnostics is performed at the centralised laboratory at Center of Specialized Medical Aid in Tver. This laboratory examines samples sent from the regional branches and different city medical institutions, as well as samples collected from patients consulting physicians at its own Center. The test result is delivered either to the treating physicians or directly to the patient. Microscopy of Gram and methylene blue stained smears were the main methods for diagnosis of Neisseria gonorrhoeae and Trichomonas vaginalis infections. However, PCR was available for testing for Chlamydia trachomatis, N. gonorrhoeae, Mycoplasma genitalium, Gardnerella vaginalis, M. hominis and Ureaplasma urealyticum using Russia-produced diagnostic tests. Serology remained in use for diagnosis of chlamydial infection and trichomoniasis. No appropriate and complete quality assurance and control system was available.
Conclusions In Tver, Russia, the detection of several STI agents has to be optimised, and international evidence-based standards and appropriate quality management systems introduced. Beneficially, the laboratory diagnosis is further centralised, which makes it easier to implement appropriate international evidence-based STI guidelines.
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