TITLE:
Misdiagnosis of Sexually Transmitted Diseases in Hong Kong Outpatient Private Healthcare
AUTHORS:
Andes Lau, David W. Y. Ho
KEYWORDS:
Sexually Transmitted Diseases (STDs), Diagnostic Error, Misdiagnosis, Incorrect Decision
JOURNAL NAME:
Open Journal of Medical Microbiology,
Vol.13 No.1,
February
20,
2023
ABSTRACT: Background and objective:
Early and accurate diagnosis is one of the critical requirements for successful
management of all diseases. Yet, delayed diagnosis and misdiagnosis remain as
vital problems, consequently impose adverse effects on patient treatment.
Sexually transmitted disease (STD) is one of the most common infectious
diseases, and more than one million of STD cases are acquired every day
globally. Misdiagnosis of STD inevitably exists, therefore should not be
overlooked. Being a medical diagnostic laboratory providing various STDs
diagnosing service in Hong Kong, we aimed to determine the misdiagnosis rate of
STDs and investigate the possible underlying cause. Methods: Specimens
were collected for STD diagnosis from multiple clinics during 1 June 2021 to 20
October 2021 from different clinics and hospitals were included in the study.
DNA extraction was performed using magnetic bead based method; then the extracted DNA was tested using the DiagCor GenoFlowTM STD Array kit to detect the existence of any targeted pathogens. Results: 1459 specimens were collected and included during the designated time period,
with 643 specimens found to be positive with at least one targeted STD
pathogen. 494 of these were found to be aligned with test ordered by
physicians, and the remaining 149 positive cases had at least one pathogen
detected but not requested to be tested by the physicians resulting in misdiagnosis. The overall misdiagnosis rate was
determined to be 23.2% (149/643), with high frequency of misdiagnosis
occurred to tests ordered for one to three pathogens detection. Also, Ureaplasma urealyticum and/or Ureaplasma parvum (UU/UP) was the commonest pathogen detected in this study. Conclusion:
The findings suggested incorrect test selection made by physicians was one of
the major reasons of STDs misdiagnosis in outpatient settings. To reduce
diagnostic errors in STD diagnosis, physicians are encouraged to select and
request test that allow detection of multiple pathogens, as co-infection of
multiple pathogens in STD patients is commonly observed. The correct selection
of test would not only benefit the patient, but also the public health.