Molecular diagnosis of chlamydia trachomatis, neisseria gonorrhoeae, trichomonas vaginalis and HPV among females seeking gynecological check-ups in Beirut, Lebanon

Abstract

Background: A global estimate for the rates of sexual transmitted infections (STIs) indicates that there are about one million new infections every day reaching about 357 million per year. Developing countries represent 80-90% of the global burden of STIs where there is lack of monitoring and control of such diseases. Lebanon likewise misses the surveillance systems needed especially after the changing sociocultural norms of sexuality which is being practiced more freely. Carriage of these so called "silent infections" not only harms the individuals but also increase their risk of complications and adverse effects of such diseases. Methods: A total of 505 vaginal and cervical specimens were collected from women above 17 years old. Women were either asymptomatic or had signs and symptoms related to gynecological infection. Nucleic acid was extracted and samples were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Human papillomavirus using three assays: in house multiplex real time PCR assay, EUROArray STI and Allplex STI Essential assays. Samples were screened for HPV genotypes using EUROArray HPV kit. Results: The percentages of infection positivity out of the 505 women tested were as follows: 6.7% HPV, 2% TV, 0.8% CT and 0.2% NG. HPV was detected as a single infection in 6 samples, double infection in 14 samples, triple infection in 9 samples and quadruple infection in 5 samples. The HPV positive samples had varied HPV genotype combinations of HR-HPV and LR-HPV with different prevalence rates and percentages. Data reveals the prevalence of 17 HR-HPV genotypes detected in samples; highest rates being recorded for types 16 and 18. A lower prevalence of LR-HPV was observed. Conclusion: The Lebanese government should implement policies that facilitate the effort of preventing STIs such as vaccination, implementing behavior change, providing accessible information service systems especially to young people, developing inexpensive STI molecular diagnostic technologies and strengthening STI surveillance systems.