Table 5. Laboratory methods to diagnose syphilis, gonorrhoea and chlamydia, six WHO European Region countries, 2015–2019.
| Belarus | Georgia | Kazakhstan | Montenegro | Serbia | Ukraine | |
|---|---|---|---|---|---|---|
| Laboratory methods used to confirm a case of syphilis | ||||||
| Detection of T. pallidum antibodies by screening test (TPHA, TPPA or EIA) | + | + | + | + | + | + |
| RPR/VDRL | + | + | + | + | + | + |
| Detection of IgM antibodies to T. pallidum | + | + | + | + | + | + |
| Demonstration of T. pallidum in lesion exudates or tissues | + | + | + | − | − | + |
| - Dark-field microscopic examination | + | + | + | − | − | + |
| - Direct fluorescent antibody T. pallidum test | − | − | + | − | − | − |
| - Molecular detection | − | − | − | − | − | + |
| Other | +a | − | − | − | +b | − |
| Laboratory methods used to confirm a case of congenital syphilis | ||||||
| Demonstration of T. pallidum in the umbilical cord, the placenta, a nasal discharge or skin lesion material | − | + | − | − | − | + |
| - Dark-field microscopic examination | − | + | − | − | − | + |
| - Direct fluorescent antibody T. pallidum test | − | − | − | − | − | − |
| Detection of T. pallidum-specific IgM | + | + | + | + | + | + |
| Reactive non-treponemal test (VDRL, RPR) in the baby's/child’s serum | + | + | + | + | + | + |
| Other | +a | - | - | - | +c | +d |
| Laboratory methods used to confirm a case of gonorrhoea | ||||||
| Isolation and confirmation of N. gonorrhoeae from a clinical specimen | + | - | + | + | + | + |
| Detection of N. gonorrhoeae nucleic acid in a clinical specimen | + | + | + | + | + | + |
| - Genital samples | + | + | + | + | + | + |
| - Rectal samples | + | + | - | - | - | + |
| - Pharyngeal samples | + | - | - | - | - | + |
| Demonstration of N. gonorrhoeae by a non-amplified nucleic acid probe test in a clinical specimen | − | − | − | − | − | − |
| Microscopic detection of intracellular Gram-negative diplococci in an urethral male specimen | + | + | + | + | + | + |
| Identification of culture | + | + | + | + | + | + |
| - Gram | + | + | + | + | + | + |
| - Oxidase | + | + | - | + | + | + |
| - Biochemical tests | - | + | - | - | - | + |
| - Molecular tests | + | - | + | - | + | + |
| Other | − | − | − | − | − | − |
| Laboratory methods used to confirm a case of chlamydia | ||||||
| Isolation of C. trachomatis from a specimen of the anogenital tract or from the conjunctiva | + | + | - | - | - | - |
| Demonstration of C. trachomatis by DFA test in a clinical specimen | + | + | + | - | + | + |
| Detection of C. trachomatis nucleic acid in a clinical specimen | + | + | + | + | + | + |
| - Genital samples | + | + | + | + | + | + |
| - Rectal samples | + | + | - | - | - | + |
| - Pharyngeal samples | + | - | - | - | - | + |
| Other methods | +e | +f | - | - | - | - |
+: method available; −: method not available; C. trachomatis: Chlamydia trachomatis; DFA: direct fluorescent antibody; EIA: enzyme immunoassays; N. gonorrhoeae: Neisseria gonorrhoeae; RPR: rapid plasma reagin; T. pallidum: Treponema pallidum; TPHA: T. pallidum haemagglutination assay; TPPA: T. pallidum particle agglutination assay; VDRL: venereal disease research laboratory test; WHO: World Health Organization.
a Passive hemagglutination reaction, indirect immunofluorescence, immunoblotting performed when the results of other treponemal tests are questionable or contradictory.
b Line blot.
c TPHA.
d In most laboratories, a non-treponemal test used is microprecipitation reaction (modification of VDRL).
e Culture (for women only), immunofluorescence reaction.
f EIA.