FIRST-VOID URINE TESTING FOR CHLAMYDIA-TRACHOMATIS BY POLYMERASE CHAIN-REACTION IN ASYMPTOMATIC WOMEN

Background: Because Chlamydia trachomatis infections are usually asymp tomatic or minimally symptomatic, diagnosis is often delayed. Goal: To perform a comparative study of first-void urine (FVU) polymerase chai n reaction (PCR) testing and endocerv ical swab antigen testing in the diagnosis of C. trachomatis infection among asymptomatic women. Study Design: The study population consisted of 1,090 unselected women atte nding a family planning clinic or: a university student health clinic. Calculations of test performances were based on an expanded reference standard including enzyme immunoassay (EIA) or PCR tests confirmed by direct fluorescence antibody (DFA) test or major outer membrane prote in PCR test, respectively. Results: The overall prevalence of C. trach omatis infection was 5,6%. After resolution of discrepant specimens, F VU PCR detected 85% (52/61) and endocervical swab EIA/DFA 90% (55/61) of confirmed positive cases. Conclusions: These results indicate that the PW PCR test is an accurate, noninvasive screening method and can r eplace endocervical swab EIA in the detection of C. trachomatis infect ion in low-prevalence populations.