title: Prevalence of Chlamydia trachomatis infection among low- and high-risk Filipino women and performance of Chlamydia rapid tests in resource-limited settings.
abstract: The prevalence of urogenital Chlamydia trachomatis infection was determined with a PCR-based test of women from low- and high-risk populations in Iloilo City, Philippines, between August 2002 and March 2006. Two rapid tests for C. trachomatis, Clearview Chlamydia MF and the Chlamydia Rapid Test (CRT), were also evaluated in these resource-limited settings. Specimens were obtained from female sex workers (FSWs; n = 1,484) attending a social hygiene clinic (SHC) and from women (n = 838) attending an obstetrics-gynecology (OB-GYN) clinic. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the rapid tests were determined, with PCR as the gold standard. The PCR positivity rate for SHC participants (72% asymptomatic) ranged from 17.9 to 32.0% during the study period. Compared with those of PCR, the sensitivities and specificities of the Clearview test were 53.5 and 99.1%, respectively, with endocervical swab specimens (CS; n = 822) from the FSWs and 31.1 and 95.2%, respectively, with vaginal swab specimens (VS; n = 333) from these women. The sensitivity, specificity, PPV, and NPV of the CRT with VS from the FSWs were 71.0, 99.0, 97.1, and 87.9%, respectively. At the OB-GYN site, the PCR positivity rate with VS was 6.3%. The sensitivity, specificity, PPV, and NPV of the CRT with these specimens were 86.8, 99.6, 93.9, and 99.1%, respectively. The performance of the Clearview test at the SHC was thus markedly lower with VS than with CS, whereas the CRT performed well with VS from both populations.
authors.affiliation: Department of Obstetrics and Gynecology, Western Visayas Medical Center, Iloilo City, Philippines.
authors.forename: Francis
authors.initials: F
authors.lastname: Saison
authors.forename: Lourdes
authors.initials: L
authors.lastname: Mahilum-Tapay
authors.forename: Claude-Edouard E
authors.initials: CE
authors.lastname: Michel
authors.forename: Nigel D
authors.initials: ND
authors.lastname: Buttress
authors.forename: Elpidio Cesar B
authors.initials: EC
authors.lastname: Nadala
authors.forename: Jose Paolo V
authors.initials: JP
authors.lastname: Magbanua
authors.forename: Emma M
authors.initials: EM
authors.lastname: Harding-Esch
authors.forename: M Odeta
authors.initials: MO
authors.lastname: Villaruel
authors.forename: Lorna
authors.initials: L
authors.lastname: Canong
authors.forename: Rey L
authors.initials: RL
authors.lastname: Celis
authors.forename: Helen H
authors.initials: HH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000821:virology*; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000382:microbiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010679:Philippines / Q000453:epidemiology; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014621:Vagina / Q000821:virology*