Peter Piot

E. van Dyck

A. Meheus

This manual provides an authoritative guide to standard laboratory procedures for detecting and diagnosing sexually transmitted diseases. Addressed to clinical microbiologists and medical technologists, the manual is designed to serve as a practical bench aid, tuned to the needs and capacities of laboratories at different levels in the health system. Although the standard procedures described have universal relevance, particular attention is given to conditions in developing countries, where rapid transport of specimens may not be possible and cost factors may be decisive. Recommended procedures, tests, and techniques are supported by close to 150 references. Noting the constraints on staff and resources faced by most laboratories throughout the world, the manual concentrates on tests known to yield essential diagnostic information. Standard antimicrobial susceptibility tests are described for those diseases where drug resistance is a problem. Although the major emphasis is on procedures for diagnosis, case-finding, and test-of-cure, some procedures useful in epidemiological research are also included. The manual has nine chapter covering the full range of sexually transmitted diseases: gonorrhoea "Chlamydia trachomatis "infection, syphilis, genital herpes, chancroid granuloma inguinale, vaginitis in adults, human papillomavirus infection, and human immunodeficiency virus. Each chapter opens with a brief description of the disease and the principal laboratory approaches to diagnosis, followed by detailed advice on the collection and transport of specimens. Against this background, all relevant laboratory methods, from microscopy, culture and non-culture techniques to serology and the use of commercial test kits, are described in detail, with colour plates used to illustrate selected procedures and results. Apart from providing detailed step-by-step instructions for each procedure, the manual offers abundant practical advice on the selection of tests, their comparative sensitivity, and specificity, the degree of skill required, the correct interpretation of results, and common errors and how to avoid them. The chapter on HIV infection reproduces the latest joint UNAIDS and WHO recommendations for the selection and use of HIV antibody tests. Further practical guidance for each of these diseases is provided in three annexes, which summarize appropriate diagnostic tests at different levels of the laboratory system, describe the media, reagents, and stains required for the tests, and list all the basic products needed to prepare essential reagents and media.

E. van Dyck

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