P2.062 Optimizations and Quality Assurance of the Laboratory Diagnosis and Treatment of Sexually Transmitted Infections in Belarus

Abstract

Background: In 2007-2008, a questionnaire-based study evaluated the quality of the 316 State laboratory services that were engaged in diagnosis of STIs in Belarus. This comprehensive survey clearly demonstrated that many of the tests and testing algorithms used in the laboratory diagnosis were inappropriate and not in accordance with international evidence-based recommendations. Methods: STI specialists from Belarus actively participated in the development of Eastern European consensus guidelines for the diagnosis of several STIs; an international collaborative work by the Eastern European Network for Sexual and Reproductive Health (EE SRH). Results: The international evidence-based guidelines developed by the EE SRH have subsequently been adapted to national conditions and legalised by the Ministry of Health of Belarus as the national standard for laboratory diagnosis of STIs. Briefly, antibody testing for diagnosis of genital Chlamydia trachomatis and Trichomonas Vaginalis infections has been abandoned. Internationally validated nucleic acid amplification tests (NAATs) have been strongly promoted and also introduced for diagnosis of several STIs. Diagnosis of Mycoplasma genitalium using NAATs was initiated and routine screening and/or testing for Ureaplasma urealyticum, Mycoplasma hominis, Gardnerella Vaginalis and Mobiluncus spp. was excluded from the recommendations supported by the State. Laboratory specialists from the 11 laboratories of the dermatovenereological dispensaries were trained in diagnostics using NAATs and laboratories supplied by the necessary equipment and reagents for NAAT diagnostics. The cultivation of Neisseria gonorrhoeae has been optimised and gonococcal antimicrobial resistance surveillance has been established. Finally, evidence-based national STI clinical protocols, including treatment recommendations, have been elaborated and legalised by the Ministry of Health of Belarus. Conclusion: The international EE SRH collaborative project has significantly improved the quality of the STI diagnostics and treatment in Belarus. A new EE SRH project is planned for Belarus, aiming to monitor and evaluate the implementation of the current developments.