Feasibility of patient-collected vulval swabs for the diagnosis of Chlamydia trachomatis in a family planning clinic: A pilot study

This pilot study set our to determine the feasibility of using patient-coll ected vulval swabs, instead of urine, for the diagnosis of female Chlamydia trachomatis infection. Main outcome measures included prevalence of infect ion and sensitivity, specificity, and acceptability of both test methods. A n assessment was also made of those who declined to be tested. Consecutive women under 25 years of age attending a single urban family planning clinic were invited to participate. Sixty-eight percent (103/152) agreed to under go testing. Overall prevalence was 11.7%. The sensitivity/specificity for t he ligase chain reaction (LCR) assayed patient-collected vulval swabs and u rine was 100%/100% and 92%/100%, respectively The acceptability of self-col lection was high with 93% characterising the test as 'not bad', 79% recomme nding it to a friend and 79% choosing the test next time. Significantly mor e women, however would choose urine for testing on a subsequent occasion (p < 0.001). Less than 1/5 of the patients who declined did not take part bec ause of concerns regarding the vulval swab. Patient-collected vulval swabs assayed by LCR represent a non-invasive, sensitive, and acceptable way to d etect genital C. trachomatis infection in women attending a family planning clinic. Compared with urine testing, benefits in terms of transport and pr ocessing should encourage more widespread use of this approach.