URINE AS AN ALTERNATIVE IO URETHRAL SWABS FOR THE DIAGNOSIS OF CHLAMYDIA-TRACHOMATIS IN INFERTILE MALES

Swabbing the urethrae of men has been the traditional approach for col lecting specimens for detection of Chlamydia trachomatis. Recently, ho wever, urine testing using enzyme immunoassay has yielded promising re sults. A total of 105 patients attending the Andrology Clinic at Ga Ra nkuwa Hospital, Medunsa were included in the study. These patients wer e asymptomatic and had no urethral discharge. Three endo-urethral swab s and first-catch urine were collected from each patient. The urethral swabs were used for enzyme immunoassay (EIA) (IDEIA III), tissue cult ure and direct immonufluorescent antibody (DFA) test (IMAGEN) to detec t C. trachomatis. In addition about 15-30 ml of first-catch urine, or urine collected at least 2h after the previous micturition, was collec ted for each patient for EIA testing. Fifteen (14.3%) of 105 patients were positive on urethral swab EIA, in comparison with the DFA test in which 14 (13.3%) were positive. Eight (7.8%) were positive in tissue culture. Urine EIA was positive in 17 (16.2%) patients, of whom five ( 4.8%) were positive in urine EIA only. All EIA positive urines were co nfirmed by DFA. We recommend that first-catch urine or urine collected at least 2h after the previous micturition in infertile males may be considered a suitable alternative to urethral swab for chlamydial diag nosis because it is noninvasive and nontraumatic.