Sexually transmitted infections in Lithuania

Abstract

In Lithuania there are three notifiable bacterial sexually transmitted infections (syphilis, gonorrhoeae and chlamydial infection) and one viral (HIV). The STIs are diagnosed and managed following the recommendations of IUSTI guidelines and reported if a person meets clinical, laboratory and epidemiological criteria. Laboratory criteria are crucial for notifiable STIs. The main routine laboratory tests such as microscopy of genital smears, serology for syphilis (RPR, TPHA), serology for HIV are available in the laboratories of bigger hospitals or even primary health centers. Laboratory tests for complicated STIs (e.g. VDRL-CSF for neurosyphilis, TP IgM antibodies for congenital syphilis, PCR for congenital herpes infection) as well as antibiotic resistance control are concentrated at the laboratories of the university hospitals and National Public Health Surveillance Laboratory (NVSPL). Different molecular tests for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomona vaginalis, Mycoplasma genitalium, ureoplasmas are introduced in university hospitals, NVSPL and private laboratories. Nucleic acid amplification tests for STIs are not covered by health insurance and the patients have to pay for them. The incidence rates over the last 3 years (2012–2014) for syphilis ranged from 7.6 to 8.8 cases/100000 population, for gonococcal infection, from 7.3 to 5.6 cases, and for chlamydial infection, from 8.9 to 15.3 cases. In recent years several epidemiological projects on STIs in Kaunas have shown that young people actively seek for timely STIs testing and treatment. In 2013 at the Hospital of Lithuanian University of Health Sciences, a cross sectional study was designed. The participants completed a standardized questionnaire. First voided urine (FUV) samples were analysed for the presence of 7 urogenital pathogens: Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonasvaginalis, Mycoplasma hominis, Mycoplasma geni