title: Diagnostic accuracy of rapid tests for sexually transmitted infections in symptomatic women.
abstract: OBJECTIVE
  To determine the diagnostic accuracy of tests developed for use at the point of care for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and syphilis in women having symptoms of lower urinary tract infection.
  
  
  METHODS
  Cross-sectional study involving sexually active 14-49-year-old women with lower urinary tract infection symptoms consulting during 2010 at a private health clinic and at two public hospitals in Bogotá, Colombia. Pregnant women, those with a previous hysterectomy or those who received antibiotics during the previous 7 days were excluded. Sequential sampling was used; sample size: 1500 women. The ACON NG and CT duo test combo and the ACON individual test plates for NG and separately for CT were used. The QuickVue Chlamydia rapid test (RT) was also used. All of them were compared with nucleic acid amplification methods. The SD Bioline 3.0 and ACON test for syphilis were evaluated and compared with serological tests. Sensitivity and specificity were estimated.
  
  
  RESULTS
  CT RTs had a sensitivity that ranged between 22.7% and 37.7% and specificity between 99.3% and 100%. Sensitivity for NG with ACON Duo was 12.5% and specificity 99.8%. Tests for syphilis had a sensitivity of 91.6-100% and a specificity of 99.7-97.8%.
  
  
  CONCLUSIONS
  The RTs studied are not useful for screening for NG at the point of care. In case of CT a recommendation about their use in routine care should be supported by a cost-effectiveness analysis. In screening populations at high risk of sexually transmitted infections or pregnant women, the RTs for syphilis should be used.
authors.affiliation: Secretaría Distrital de Salud de Bogotá, Bogotá, Colombia.
authors.forename: Lilian
authors.initials: L
authors.lastname: Nuñez-Forero
authors.affiliation: Secretaría Distrital de Salud de Bogotá, Bogotá, Colombia.
authors.forename: Luisa
authors.initials: L
authors.lastname: Moyano-Ariza
authors.affiliation: Department of Obstetrics and Gynaecology, Clinical Research Institute, Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Hernando
authors.initials: H
authors.lastname: Gaitán-Duarte
authors.affiliation: Department of Obstetrics and Gynaecology, Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Edith
authors.initials: E
authors.lastname: Ángel-Müller
authors.affiliation: Department of Obstetrics and Gynaecology, Clinical Research Institute, Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Ariel
authors.initials: A
authors.lastname: Ruiz-Parra
authors.affiliation: Secretaría Distrital de Salud de Bogotá, Bogotá, Colombia.
authors.forename: Patricia
authors.initials: P
authors.lastname: González
authors.affiliation: Clinical Research Institute, Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rodríguez
authors.affiliation: Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA FUNDARED-MATERNA, Bogotá, Colombia.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Tolosa
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission; D003105:Colombia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008875:Middle Aged; D000067716:Point-of-Care Testing; D015203:Reproducibility of Results; D013587:Syphilis / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000382:microbiology; D016387:Women's Health
keywords: CHLAMYDIA TRACHOMATIS; DIAGNOSIS; NEISSERIA GONORRHOEA; SYPHILIS; TESTING