Table 1

Diagnostics for major STI syndromes

Major STI syndromesPathogensExisting technologiesNew technologies
Urethral discharge

  • Chlamydia trachomatis

  • Neisseria gonorrhoeae

  • Antigen detection: enzyme immunoassay or rapid antigen test

  • NAAT

  • Rapid multiplex NAATs:

    • GeneXpert,

    • Recombinase Polymerase Amplification,

    • Rolling Circle Amplification

    • and other rapid NAATs

Vaginal discharge

  • Chlamydia trachomatis,

  • Neisseria gonorrhoeae

  • Trichomonas vaginalis

  • Bacterial vaginosis

  • Antigen detection: enzyme immunoassay or rapid antigen test

  • NAAT

  • Microscopy

  • Rapid multiplex NAATs:

    • GeneXpert,

    • Recombinase polymerase amplification,

    • Rolling circle amplification

    • and other rapid NAATs

Genital ulcer

  • Haemophilus ducreyi

  • Culture

If ulcer present: Rapid multiplex NAAT

  • Herpes simplex type 2

  • Serology, NAAT

Serology: Rapid multiplex testing, or in combination with HIV, syphilis and/or Hepatitis B or C

  • Treponema pallidum

  • Dark field microscopy

  • Serology:

    • Non-treponemal tests: RPR/VDRL

    • Treponemal tests:

  • TPHA/TPPA/Rapid tests

  • Serology

    • Rapid duplex non-treponemal and treponemal tests

    • Rapid treponemal tests using oral fluid

Genital wartsHuman papilloma virus

  • Rapid antigen detection

  • NAAT

Rapid NAAT

  • NAAT, nucleic acid amplified test; RPR, rapid plasma reagin; STI, sexually transmitted infection; TPHA, Treponema pallidum haemagglutination assay; TPPA, Treponema pallidum Particle Agglutination assay; VDRL, Venereal Disease Research Laboratory.