Is there any role for rapid tests for <i>Chlamydia                   trachomatis</i>?

Rani, Ranjana; Corbitt, Gerald; Killough, Rosemary; Curless, Eric

doi:10.1258/0956462021924569

Cited by 27 publications

(26 citation statements)

References 9 publications

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“…The results of the present study are consistent with those obtained in previous validations of similar assays conducted in the laboratory setting (8) and the clinical setting (3) with specimens from women at high risk for C. trachomatis infection. However, some recent studies of other rapid tests with cervical swab specimens conducted in reference STI clinic settings in developing countries found the sensitivities of rapid tests compared with the results of PCR to be poor (49.7% to 53.5%) (9,17).…”

supporting

confidence: 91%

“…However, some recent studies of other rapid tests with cervical swab specimens conducted in reference STI clinic settings in developing countries found the sensitivities of rapid tests compared with the results of PCR to be poor (49.7% to 53.5%) (9,17). The specificity of the rapid POC test was excellent and in the range found in previous evaluation studies in which PCR was used as the reference test (97.9% to 100.0%) (3,4,5,8,9,17).…”

mentioning

confidence: 76%

“…The currently available rapid tests for the detection of C. trachomatis have reasonable specificities, but they are relatively insensitive compared to other methods (7). Their reported sensitivities and specificities for endocervical swab specimens are 49.7% to 95% and 97.9% to 100%, respectively, compared with the results of PCR (4,5,7,8,9,17). The Sexually Transmitted Diseases Initiative claimed as a priority the evaluation of rapid C. trachomatis tests that can be used to screen high-risk populations (16).…”

mentioning

confidence: 99%

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Clinic-Based Evaluation of a Rapid Point-of-Care Test for Detection of Chlamydia trachomatis in Specimens from Sex Workers in Escuintla, Guatemala

Sabidó

Hernández²,

González³

et al. 2009

J Clin Microbiol

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We evaluated a rapid point-of-care test for the detection of Chlamydia trachomatis in specimens from 278 sex workers attending sexually transmitted infection clinics in Guatemala. The sensitivity and the specificity of the test compared to the results of PCR were 62.96% and 99.60%, respectively. The test performed moderately well as a screening tool in a context in which clinical follow-up visits are infrequent.Laboratory screening has been suggested to be an effective strategy for reducing the prevalence of Chlamydia trachomatis infection in sex workers (SWs) (11). Rapid point-of-care (POC) tests can be a cost-effective strategy for increasing the impact of screening interventions for sexually transmitted infections (STIs) in both SWs and their clients (14). Their greatest value is that they can yield the results at the time of the initial patient visit and do not require patient follow-up (6), the rate of failure of which is as high as 50% among STI clinic populations (10). The use of rapid POC tests of moderate sensitivity combined with immediate on-site treatment may lead to the treatment of more infected women than the use of PCR alone when the return rate is low (3). The currently available rapid tests for the detection of C. trachomatis have reasonable specificities, but they are relatively insensitive compared to other methods (7). Their reported sensitivities and specificities for endocervical swab specimens are 49.7% to 95% and 97.9% to 100%, respectively, compared with the results of PCR (4,5,7,8,9,17). The Sexually Transmitted Diseases Initiative claimed as a priority the evaluation of rapid C. trachomatis tests that can be used to screen high-risk populations (16). Our aim was to evaluate the performance of a rapid C. trachomatis test compared with that of the current "gold standard" assay (PCR) with specimens from female SWs in the context of its specific application.Study setting and populations. The study was conducted in three STI clinics located in the province of Escuintla, Guatemala. The clinics were set up by the Fundació Sida i Societat, a nonprofit organization that has been offering to SWs regular screening and treatment for human immunodeficiency virus infection and STIs since 2004. Between April and August 2007, we recruited consecutive female SWs attending the clinics who were at least 18 years of age, willing to participate, and not currently menstruating and who had not used antibiotics within the previous 3 weeks. The women were interviewed, and specimens were collected by trained medical doctors. Testing for C. trachomatis is included in the regular screening for SWs, for which written consent is obtained. Therefore, consent specifically for this study was considered unnecessary.Specimen collection, transport, and processing. Two cervical swab specimens were collected from each participant and were always collected in the same sequence (a sample was collected for the rapid test, followed by collection of a sample for PCR). We used a Dacron swab to collect samples for the rapid C. t...

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supporting

confidence: 91%

mentioning

confidence: 76%

mentioning

confidence: 99%

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Clinic-Based Evaluation of a Rapid Point-of-Care Test for Detection of Chlamydia trachomatis in Specimens from Sex Workers in Escuintla, Guatemala

Sabidó

Hernández²,

González³

et al. 2009

J Clin Microbiol

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“…Therefore, false-negative QuickVue Chlamydia test results would not have been detected, and performance of the QuickVue Chlamydia in this study has been overestimated. In 2002, a second evaluation was published comparing QuickVue Chlamydia with NAAT in two groups of 100 women 23. In the high-risk population, sensitivity and specificity were 65% and 100%, respectively, with 16 women being positive with NAAT.…”

Section: Discussionmentioning

confidence: 99%

Alarmingly poor performance in Chlamydia trachomatis point-of-care testing

Dommelen

Tiel

Ouburg

et al. 2010

Sexually Transmitted Infections

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Background Infection by Chlamydia trachomatis (CT) is the most prevalent sexually transmitted infection (STI) world wide. The most frequently used diagnostic test for CT is a nucleic acid amplification test (NAAT), which is highly sensitive and specific. To further shorten time delay until diagnosis has been made, in order to prevent CT spread, the use of point-of-care (POC) tests may be the way forward. Objectives The diagnostic performance of three POC tests, Handilab-C, Biorapid CHLAMYDIA Ag test and QuickVue Chlamydia test, was evaluated and compared with NAAT. Methods All women, above the age of 16 years, attending for a consultation at an STI clinic between September 2007 and April 2008, were asked to participate. Women were asked to complete a short questionnaire and to collect six self-taken vaginal swabs (SVS). SVS 2 was used for NAAT and SVS 3 to 5 were randomised for the different POC tests. SVS 1 and 6 were used for determining quantitative CT load to validate the use of successive SVS. All POC tests were performed without knowledge of NAAT results. NAAT was used as the 'gold standard'. Results 772 women were included. CT prevalence was 11% in our population. Sensitivities of the Biorapid CHLAMYDIA Ag test, QuickVue Chlamydia and Handilab-C test were 17%, 27% and 12%, respectively. Conclusions The evaluated POC tests, owing to their very low sensitivities, are not ready for widespread use. These results underline the need for good-quality assurance of POC tests, especially in view of the increased availability of these tests on the internet.

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“…Results are available 30 min after sample collection, but the consensus on these tests seems to be that they sacrifice sensitivity for speed (174,246).…”

Section: Enzyme Immunoassaymentioning

confidence: 99%

Diagnosis and Assessment of Trachoma

et al. 2004

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Trachoma is caused by Chlamydia trachomatis. Clinical grading with the WHO simplified system can be highly repeatable provided graders are adequately trained and standardized. At the community level, rapid assessments are useful for confirming the absence of trachoma but do not determine the magnitude of the problem in communities where trachoma is present. New rapid assessment protocols incorporating techniques for obtaining representative population samples (without census preparation) may give better estimates of the prevalence of clinical trachoma. Clinical findings do not necessarily indicate the presence or absence of C. trachomatis infection, particularly as disease prevalence falls. The prevalence of ocular C. trachomatis infection (at the community level) is important because it is infection that is targeted when antibiotics are distributed in trachoma control campaigns. Methods to estimate infection prevalence are required. While culture is a sensitive test for the presence of viable organisms and nucleic acid amplification tests are sensitive and specific tools for the presence of chlamydial nucleic acids, the commercial assays presently available are all too expensive, too complex, or too unreliable for use in national programs. There is an urgent need for a rapid, reliable test for C. trachomatis to assist in measuring progress towards the elimination of trachoma

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Is there any role for rapid tests for Chlamydia trachomatis?

Cited by 27 publications

References 9 publications

Clinic-Based Evaluation of a Rapid Point-of-Care Test for Detection of Chlamydia trachomatis in Specimens from Sex Workers in Escuintla, Guatemala

Clinic-Based Evaluation of a Rapid Point-of-Care Test for Detection of Chlamydia trachomatis in Specimens from Sex Workers in Escuintla, Guatemala

Alarmingly poor performance in Chlamydia trachomatis point-of-care testing

Diagnosis and Assessment of Trachoma

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