Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 12;61(4):714.
doi: 10.3390/medicina61040714.

Combination of Individual Tests to Improve Diagnostic Accuracy in Chlamydia trachomatis Detection

Jelena Tošić-Pajić  1 , Predrag Sazdanović  1   2   3 , Aleksandar Nikolov  1   2   4 , Dragan R Milovanović  5   6 , Violeta Ninković  7 , Jelena Čukić  7 , Slobodan Subotić  8 , Marija Šorak  1   2   4 , Dejan Baskić  7   9
Affiliations

Combination of Individual Tests to Improve Diagnostic Accuracy in Chlamydia trachomatis Detection

Jelena Tošić-Pajić et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Chlamydial infection is the most common asymptomatic infection worldwide. Despite all national programs, strategies and guidelines, chlamydial infection is still the leading infection worldwide, especially in young populations. We have tried to summarize the best diagnostic tools for its detection. Materials and Methods: In the study, 225 sexually active patients who were tested for chlamydial infection at the Institute of Public Health Kragujevac participated. Results: Combinations of direct immunofluorescence (DIF) and a rapid lateral immunochromatographic test (RT) and combinations of an RT and immunoglobulin G (IgG) do not improve diagnostic efficiency when compared to a rapid test that individually had the best parameters. In situations that require high specificity, the recommended combination is RT/IgA, which as a highly specific test has few false positive results, while the combinations of DIF + RT and RT + IgG, although showing a specificity of 100%, have low sensitivity (33.30%), due to which we prefer the RT/IgA combination. The combinations DIF + RT, DIF + RT + IgG and RT + IgG, although with low sensitivity, have the highest values of specificity, and the positive predictive value (PPV) and negative predictive value (NPV) show the highest values of the extended Youden index of 130.30% and the highest values of total diagnostic accuracy of 97.00%. Based on the results of the extended Youden index, taking into account PPV and NPV, the RT/IgA combination shows the highest value of 94.60%, as well as the highest value of total diagnostic accuracy of 93.00%. Conclusions: "Two or more positive tests" or "any test positive" did not improve the diagnostic efficiency compared to a single "rapid test".

Keywords: Chlamydia trachomatis; combination of tests; diagnostic accuracy; efficiency; single test.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Agreement of the results of RT-PCR test for detection of C. trachomatis and results obtained by a combination of “two or more tests positive”.
Figure 2
Figure 2
Agreement between the results of RT-PCR assay for detection of C. trachomatis and results obtained by “any test positive”.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Kreisel K.M., Spicknall I.H., Gargano J.W., Lewis F.M., Lewis R.M., Markowitz L.E., Roberts H., Satcher Johnson A., Song R., St Cyr S.B., et al. Sexually transmitted infections among US women and men: Prevalence and incidence estimates. Sex. Transm. Dis. 2021;48:208–214. doi: 10.1097/OLQ.0000000000001355. - DOI - PMC - PubMed
    1. CDC . Sexually Transmitted Disease Surveillance. Department of Health and Human Services; Atlanta, GA, USA: 2021. pp. 21–41.
    1. European Centre for Disease Prevention Control . Annual Epidemiological Report for 2020 [Internet] ECDC; Solna, Sweden: 2020. Introduction to the Annual Epidemiological Report.
    1. European Centre for Disease Prevention Control . Chlamydia Control in Europe—A Survey of Member States Stockholm. ECDC; Solna, Sweden: 2014.
    1. Leichliter J.S., Haderxhanaj L.T., Obafemi O.A. Increasing sexually transmitted infections among adolescents in the USA. Lancet Child Adolesc. Health. 2021;5:609–611. doi: 10.1016/S2352-4642(21)00191-7. - DOI - PMC - PubMed

Substances

LinkOut - more resources