August 2023
Ampath | ampath.co.za
Why It Matters
- Over 1 million new STIs occur globally each day
- Many are asymptomatic, yet carry serious complications like:
- HIV transmission
- Infertility
- Chronic pelvic pain
- Ectopic pregnancy
- Miscarriage
- Neonatal infections
- Syndromic management is widely used in South Africa due to affordability and simplicity, but:
- It may lead to misdiagnosis
- Encourages inappropriate treatment
- Lacks precision in recurrent or complex cases
About the STD PCR Panel
✅ Pathogens Detected
- Neisseria gonorrhoeae
- Chlamydia trachomatis
- Mycoplasma genitalium
- Trichomonas vaginalis
Note on other mycoplasmas:
- Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis are generally considered commensal flora.
- Their clinical relevance is limited, except in pregnancy, where they've been linked to adverse outcomes like chorioamnionitis.
✅ Who Should Be Tested?
- Patients with recurrent vaginal or urethral discharge
- Pregnant females with discharge
- Pregnant females exposed to partners with genital discharge
- Any patient with genital discharge who requests testing
✅ Specimen Types Accepted
- Urine
- Urethral swab
- Vaginal swab
- Liquid-based cytology
✅ Test Information
- Mnemonic:
STDPCR - Turnaround time: 48 hours (from receipt in the lab)
Ampath’s 5-Year Review Findings
- 13% of all submitted STD PCR samples tested positive for at least one pathogen
- 10% of positive cases involved mixed infections
Observed Positivity Rates:
In Males:
- Neisseria gonorrhoeae – 6%
- Chlamydia trachomatis – 5%
- Mycoplasma genitalium – 3%
- Trichomonas vaginalis – 1%
In Females:
- Neisseria gonorrhoeae – 2%
- Chlamydia trachomatis – 2%
- Mycoplasma genitalium – 2%
- Trichomonas vaginalis – 2%
Other Diagnostic Considerations
- Bacterial vaginosis and vulvovaginal candidiasis remain leading causes of discharge
- Can be tested via:
- Vaginal swab for MCS
- Bacterial vaginosis PCR (BVPCR)
Comprehensive Sexual Health Testing Should Also Include:
- HIV
- Hepatitis B and C
- Syphilis
- Cervical cancer screening
📌 For further guidance, contact your local Ampath representative or pathologist.
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