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Survey of Sexually Transmitted Disease Laboratory Methods in US Army Laboratories

Lee, Seung-eun MPH*†; Nauschuetz, William PHD; Jordan, Nikki MPH§; Lindler, Luther PHD*; Steece, Richard PHD; Pfau, Esther MPH§∥; Gaydos, Joel MD*

Sexually Transmitted Diseases: January 2010 - Volume 37 - Issue 1 - p 44-48
doi: 10.1097/OLQ.0b013e3181b66dd6

Background: Sexually transmitted diseases, in particular Chlamydia trachomatis and Neisseria gonorrhoeae, are ranked as the top 2 most commonly notified disease in the US Army. Although surveillance programs are in place to capture event data, no routine STD surveillance program captures laboratory test information.

Methods: To evaluate laboratory testing practices/methodologies in US Army laboratories in 2007, a questionnaire was distributed to all 38 US Army laboratories. The results of the survey were compared across Army installations to US civilian public health laboratories.

Results: Of 38 survey recipients, 35 (92.1%) completed the survey. Overall, 78.6% of C. trachomatis and 77.2% of N. gonorrhoeae specimens were tested by nucleic acid amplification tests. In addition, 48.6% used culture as a method of N. gonorrhoeae testing. Testing for genital herpes, trichomonas, bacterial vaginosis, syphilis, human papillomavirus, and/or premalignant/malignant cervical cells was performed by 33 of the 35 laboratories.

Conclusions: A high proportion of US Army laboratories are using NAAT technology for C. trachomatis and N. gonorrhoeae testing. A more comprehensive questionnaire may be needed to accurately describe the type and volume of other STD tests. Despite the difference in survey data acquisition between the US civilian public health laboratory survey and the US Army laboratory survey, broad comparisons such as test types were able to be made. Future surveys should be extended to other US military services and should include both civilian and military laboratories.

A survey of US Army laboratories identified the types of sexually transmitted tests used in 2007 and compared results to data for US civilian public health laboratories.

From the *Armed Forces Health Surveillance Center, Silver Spring, MD; †Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Rockville, MD; ‡U.S. Army Medical Command, Fort Sam Houston, TX; §U.S. Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, MD; ¶National Infertility Prevention Project, Pierre, SD; and the ∥Oak Ridge Institute for Science and Education, Aberdeen Proving Ground, MD

The authors thank Dr. Charlotte Gaydos, Professor of Medicine at Johns Hopkins University, for providing her technical expertise on STD laboratory methods; and Dr. Steven Tobler at the Armed Forces Health Surveillance Center, for his critical review of the manuscript.

Correspondence: Seung-eun Lee, MPH, Armed Forces Health Surveillance Center, 503 Robert Grant Ave., Silver Spring, MD 20910–7500. E-mail:

Received for publication April 10, 2009, and accepted July 7, 2009.

© Copyright 2010 American Sexually Transmitted Diseases Association