Consensus recommendations for testing of Chlamydia trachomatis,Neisseria gonorrhoeae,Trichomonas vaginalis,and Mycoplasma genitalium infections in the Asia-Pacific (APAC)—modified Delphi method

Abstract

Background

Sexually transmitted infections (STIs) are among the most common infectious diseases globally. In the Asia Pacific (APAC) region, syndromic management is widely practiced, though approaches to aetiological testing vary. Thirteen experts from across APAC convened to develop evidence-based recommendations for testing the four most common infections associated with STI syndromes: Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium.

Methods and Results

The consensus was developed according to a modified Delphi-based approach. Thirteen experts of multidisciplinary background, representing nine geographical areas in APAC, contributed to the discussion. Twenty-two statements were developed addressing five clinical questions: (1) testing and screening recommendations for these four STIs and frequency of screening, where possible; (2) antimicrobial resistance testing; (3) optimal specimen types for testing; (4) role of self-/patient-collected samples for testing; and (5) role of sample pooling (multiple sites from an individual or pooling of the same sample type from different individuals) in testing. All statements achieved strong consensus, with ≥90% agreement among the experts.

Conclusion

These recommendations, while not replacing the existing guidelines, will provide evidence-based pragmatic approach on the testing of four common STIs, which can be adapted for specific settings, depending on available resources.