Evaluation of near patient testing for Chlamydia trachomatis in a pregnancy termination service

Abstract

Aim: To identify and evaluate advantages and disadvantages of a near patient test (NPT) for Chlamydia trachomatis, using Clearview Chlamydia MF (Unipath Ltd) in a British Pregnancy Advisory Service (BPAS) clinic.

Method: The improved Clearview Chlamydia MF test was used to test endocervical swabs from 400 women attending BPAS clinic for termination of pregnancy. The results were compared with Ligase Chain Reaction (LCR), using Polymerase Chain Reaction (PCR) as the arbiter.

Results: Twenty-seven women tested positive by Clearview Chlamydia MF (24 confirmed by LCR) and 32 by LCR.

Comment: NPT has potential advantages in specific situations where a quick result is required for optimal management of those testing positive. However, the current technology available for detection of Chlamydial infection results in time constraints, which limited its benefits in this study, where there was a high throughput of clients. A significant number of cases were missed by Clearview Chlamydia MF, though the sensitivity found is within the ranges reported for various enzyme immunoassays (EIA) - currently the most commonly used testing method. The study confirmed the high positivity in those attending for termination, especially in under 25-year-olds.