Disappointing performance of literature-derived selective screening criteria for asymptomatic Chlamydia trachomatis infection in an inner-city population
Igm. Van Valkengoed et al., Disappointing performance of literature-derived selective screening criteria for asymptomatic Chlamydia trachomatis infection in an inner-city population, SEX TRA DIS, 27(9), 2000, pp. 504-507
Background In an inner-city population with a low prevalence of Chlamydia t
rachomatis infection, selective screening may be indicated to increase the
efficiency of screening.
Goal: To evaluate the performance of sets of selective screening criteria f
or asymptomatic Chlamydia trachomatis infection in an inner-city population
The criteria were derived from reports of studies carried out in various s
ettings.
Study Design: A total of 5714 women age 15 to 40 years living in Amsterdam
were invited for a screening based on home-obtained urine specimens. Criter
ia identified from the literature were applied to the screening population.
A calculated area under the receiver-operator characteristic curve (AUC) o
f greater than 0.75 was considered a good measure of diagnostic accuracy.
Results: Of the four sets of criteria, selection based on the following det
erminants showed the highest diagnostic accuracy: younger than 25 years, be
ing unmarried, number of partners during the previous 6 months, Surinam or
Antillean origin (black), and vaginal douching (AUC, 0.67; 95% CI, 0.65-0.6
9), Selection based on age done showed an AUC of 0.57 (95% CI, 0.55-0.69),
Conclusion: The performance of selective screening criteria for asymptomati
c C trachomatis infection in an inner-city population in Amsterdam was insu
fficient to recommend its implementation in practice.