Parallel observation of four methods for screening women under 25 years of age for genital infection with Chlamydia trachomatis

Abstract

Objectives: To compare four methods of screening women for Chlamydia trachomatis in an obstetrics and gynaecology department. Study design: A total of 303 healthy women under 25 years were recruited from antenatal, induced abortion, and family planning clinics. Each underwent parallel testing of endocervical specimens by enzyme immunoassay (EIA) and ligase chain reaction (LCR), vulval swabs by LCR, and urine by LCR. Outcome measures included sensitivity, specificity, acceptability of each method, and the influence of pregnancy. Results: Overall prevalence (95% CI) was 9.9% (6.8–14%). All methods had a high rate of detection (75–100%), not affected by pregnancy. Urine was most acceptable, followed by vulval swabbing. Conclusions: Opportunistic screening of women under 25 years attending obstetric and gynaecology affiliated clinics found high rates of C. trachomatis infection. Both urine and vulval swab methods were highly sensitive, acceptable, and not affected by pregnancy status. Due to pragmatic issues surrounding the urine method, screening by vulval swabs deserves wider recognition.