A simple urine test for diagnosing chlamydia in men could help reduce the risks of persistent infection and transmission to sexual partners, finds a study published on bmj.com today.
Chlamydia trachomatis infection is the most common sexually transmitted bacterial infection in the USA and UK, but often has no symptoms and remains undiagnosed. If left untreated it can lead to serious complications in women such as pelvic inflammatory disease, infertility and ectopic pregnancy. Recent evidence also suggests it may cause infertility in men.
Nucleic acid amplification based tests such as the Polymerase Chain Reaction are currently used to diagnosis infection, but they are costly, technically complex and can take several days to obtain the results.
A previous study found that the Chlamydia Rapid Test for women was sensitive and quicker when compared to the polymerase chain reaction test, so researchers assessed the performance of the same test in men.
Just over 1,200 men aged 16 to 73 years attending two clinics in the UK were included in the study. Each participant received an information sheet about the study and provided two urine samples. The first was collected using Firstburst – a device designed to collect the first 4-5 ml of urine that contains higher levels of bacteria. The second was collected using a standard urine cup.
The Chlamydia Rapid Test achieved a high level of sensitivity (82.6%) and specificity (98.5%) compared with the Polymerase Chain Reaction test when using the Firstburst device. It also provided results within one hour, thus allowing positive individuals to be offered treatment while still at the clinic.
This "test and treat" strategy, say the authors, could help reduce the risks of persistent infection and onward transmission. This approach would also be valuable in developing countries, given the high prevalence of chlamydial infection among sex workers in these settings.
These results indicate that the Chlamydia Rapid Test is suitable as a primary diagnostic tool, especially in settings where patients need to be tested and treated in one visit, say the authors.
More studies are warranted to verify whether the Chlamydia Rapid Test would reassure young men that testing can be quick, simple and non-invasive, and this might increase uptake, they conclude.
"I work in a prison setting, which is a male population of all ages ranging from 18-above. I am the Chlamydia lead nurse here, we are currently using the old samples kits where they provide the urine then sent off, however, results take almost two to come back and yet this is a remand prison with a very high turnover. I think we would benefit from Chlamydia Rapid Test kit, so that at least our patients can find out whether they are positive before they are released or transferred from this establishment" - Rashidah Namusisi