Screening, within the health context, means investigating, testing or examining a person or a group of persons identified as being at a great risk of contracting a disease, by using their blood, urine, fecal or any other bodily sample to check for the presence of the disease or any disorder in health.
Usually, screening is carried out in persons who present no symptoms of a disease but are likely to contract the disease in question if no early detection or lifestyle adjustment is made.
There are many types of screening, but for now, the discussion will be limited to the screening of Sexually Transmitted Diseases (STDs).
STDs are diseases caused by pathogens (disease-causing organisms) that are easily transmitted through sexual intercourse (vaginal sex, anal sex, and oral sex). Some of these diseases do not present with any symptom at their early stages – and that is crucial.
Their complications could be fatal if detected late or left untreated. That is why sexually active persons, people living in areas where these diseases are endemic, and people with many sexual partners or who are immunocompromised are encouraged to get screened for STDs, routinely. When detected early, treatment will be very much effective, and transmission rate of the diseases will be drastically reduced.
The following STDs will be discussed in the area of their screening:
Meyers, D. and his co-physicians, in the United States Preventive Task Force (USPTF) Recommendations for STI Screening, opined that screening for Gonorrhea should be carried out in women at increased risk of Gonorrhea infection, including all sexually active women below the age of 25.
In their article for November 2015 on Sexually Transmitted Infections, Smith, L., and his colleagues wrote that the USPTF recommends routine screening in previously Gonorrhea-positive people or those who have multiple sexual partners. People who use condom inconsistently, or who have sex under the influence of alcohol or drugs are also to be routinely screened for Gonorrhea.
The Institute for Clinical Systems Improvement in July 2010 suggests screening for Gonorrhea in women who are, or who plan to be pregnant, and who are discovered to be at a high risk of contracting STDs.
In screening for Gonorrhea, a urine sample (first-catch) or a swab of cells from the genitals are taken. Sometimes, a swab of cells from non-genitals is taken. Gonorrhea screening is to look for Neissera gonorrhea, which causes Gonorrhea.
In screening for Syphilis, a number of tests are included. However, the most common of all is the combined duo of nontreponemal and treponemal antibody tests.
The Centers for Disease Control in the 2014 article on Sexually Transmitted Diseases Surveillance declare that men who have sex with men (MSM), and men and women living with HIV are the highest risk population for contracting Syphilis.
Therefore, routine screening is recommended for them. In addition, people living in areas where Syphilis is a common infection and commercial sex workers should be routinely screened for Syphilis.
Most commonly in screening for Syphilis, a blood sample is drawn from the person about to be tested. Rarely, cerebrospinal fluid is drawn for screening. This is done through a spinal tap (for neurosyphilis test).
The most common tests are conducted to find out antibodies which are produced in response to the bacterium that causes Syphilis, known as Treponema pallidum.
Because of its asymptomatic nature, young women and girls should be screened for Chlamydia, especially the sexually active ones. Older women should be screened if they have multiple sex partners. Men with multiple partners, young men below 30 in the military and men having sex with men should also be screened for Chlamydia.
In screening for Chlamydia, a swab over the vagina or inside the anus is taken. A urine sample can also be taken one or two hours after the last urination.
Nucleic Acid Amplification Tests (NAATs) have been proven to be the most effective tests for detecting Chlamydia infection.
In screening for the presence of HIV, there are three known categories of tests available. They are HIV antibody tests, HIV antibody confirmation tests, and HIV viral load measurements. HIV viral load measurements detect the Ribonucleic Acid of HIV while HIV antibody tests and antibody confirmation tests detect antibodies produced in response to the presence of HIV in the body. The screening tests for HIV require either a blood sample, oral fluid, or urine sample to test for the virus.
Given the socioeconomic burden many STDs bring upon our society, and their potential morbid consequences, early detection and treatment are much advocated for, for persons at high risk of contracting the diseases. Complications arising from late detection and treatment are very deadly and regrettable.