Diagnostic accuracy of rapid tests for sexually transmitted infections in symptomatic women
- Lilian Nuñez-Forero1,
- Luisa Moyano-Ariza1,
- Hernando Gaitán-Duarte2,
- Edith Ángel-Müller3,
- Ariel Ruiz-Parra2,
- Patricia González1,
- Andrea Rodríguez4,
- Jorge E Tolosa5,6
- 1Secretaría Distrital de Salud de Bogotá, Bogotá, Colombia
- 2Department of Obstetrics and Gynaecology, Clinical Research Institute, Universidad Nacional de Colombia, Bogotá, Colombia
- 3Department of Obstetrics and Gynaecology, Universidad Nacional de Colombia, Bogotá, Colombia
- 4Clinical Research Institute, Universidad Nacional de Colombia, Bogotá, Colombia
- 5Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA
- 6FUNDARED-MATERNA, Bogotá, Colombia
- Correspondence to Dr Hernando Gaitán-Duarte, Calle 119 # 18–14 (Apartment 502) Bogota, Colombia;
- Received 3 October 2014
- Revised 7 April 2015
- Accepted 13 June 2015
- Published Online First 1 July 2015
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.