Diagnosis of urogenital Chlamydia trachomatis infection in women based on mailed samples obtained at home: multipractice comparative study.
OBJECTIVE
To compare urine and vaginal flush samples collected by women at home with endocervical and urethral swabs obtained by general practitioners for their efficacy in the diagnosis of urogenital Chlamydia trachomatis infection.


METHODS
Multipractice comparative study.


METHODS
33 general practices and a central department of clinical microbiology in Aarhus County, Denmark.


METHODS
222 women aged 18-25 years who for any reason had a gynaecological examination.


METHODS
Endocervical and urethral swabs were obtained by the women's general practitioners. The same women when at home then collected a first void urine sample, a midstream urine sample, and a vaginal flush sample (using a vaginal pipette) and mailed them to the laboratory.


METHODS
C trachomatis defected by the polymerase chain reaction and the ligase chain reaction. Eight tests for C trachomatis were performed for every woman. When two of the eight yielded positive results the patient was considered infected.


RESULTS
The overall prevalence of C trachomatis infection was 11.2% (23/205 women). Test sensitivities in samples obtained by general practitioners, samples obtained at home subjected to polymerase chain reaction, and samples obtained at home subjected to ligase chain reaction were 91%, 96%, and 100% respectively. The corresponding specificities were 100%, 92.9%, and 99.5%.


CONCLUSIONS
The diagnostic efficacy of samples obtained by women at home and mailed to the laboratory was as good as for samples obtained by a general practitioner when using the ligase chain reaction. This may have important implications for the practicability of screening for this common, often asymptomatic, and treatable infection.
Department of Infectious Diseases, Aarhus University Hospital, Denmark.
L
L
Ostergaard
J K
JK
Møller
B
B
Andersen
F
F
Olesen
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis; D005194:Family Practice; D005260:Female; D052776:Female Urogenital Diseases / Q000175:diagnosis*; D006699:Home Care Services; D006801:Humans; D012648:Self Care; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D016482:Urinalysis