Rapid chlamydia test for men examined
Research of an experimental urine test indicates that it successfully diagnoses chlamydia infection in men within the hour, which improves the ability to successfully treat the infection on the spot and prevent retransmission.1
If clinicians are to stem the tide in the spread of chlamydia, they have to be able to improve their ability to diagnose and treat the infection, says Ted Bianco, PhD, FIBiol, director of the London-based Wellcome Trust's Technology Transfer Division, which funded the test's development. The trust is an independent charity that funds research to improve human and animal health.
"Right now, our tests are too slow to permit on-the-spot treatment or too insensitive to detect an adequate proportion of cases," said Bianco in an announcement of the published research. "The new assay offers a way forward."
Chlamydia infection can cause suboptimal fertility in men and pelvic inflammatory disease, chronic pelvic pain, infertility, and ectopic pregnancy in women. The chlamydia rate among women in the United States continues to outpace men's numbers; in 2007, the chlamydia rate among women was three times that of men (543.6 cases per 100,000 women, compared to 190 cases per 100,000 men).2 Population-based data from the National Health and Nutrition Examination Survey indicate that prevalence of chlamydia among teens ages 14-19 is higher among females [4.6%; 95% confidence interval (CI) = 3.7-5.8] than males [2.3% (CI = 1.5-3.5)]. As the age increases, the trend reverses; in young adults ages 20-29, chlamydia prevalence is greater among males (3.2%; CI = 2.4-4.3) than among females (1.9%; CI = 1.0-3.4).3
The Centers for Disease Control and Prevention (CDC) recommends annual chlamydia screening for all sexually active women under 26 years old. (See article, below, for recommendation highlights.) While the CDC currently does not have recommendations for the routine screening of men for chlamydia, modeling studies are under way that will help address the relative value of screening men for infection, says Nikki Kay, CDC spokeswoman.
Scientists at Diagnostics for the Real World and the University of Cambridge, both in England, have designed the Chlamydia Rapid Test as a urine-based screening tool that can be used with minimal training. The test is designed to be used in conjunction with FirstBurst, a device for collecting the first voided urine from men. Research data indicate FirstBurst collects six times the amount of chlamydia bacteria compared to a standard urine sample.4 The test then uses a unique signal amplification system developed by scientists to boost the test's sensitivity and yield results in less than an hour.
To perform the currently published study, researchers took samples from more than 1,200 men at two clinical sites. They found that the test correctly identified chlamydia infection in 84.1% of samples, more accurate than the nearest competitor rapid tests for men.1
The Chlamydia Rapid Test has received regulatory approval and is now on the market in France. The test is scheduled to appear in Spain, Portugal, Italy, and a number of other European countries in the near future, according to the Wellcome Trust.
More options are needed for chlamydia testing, state the researchers. Current nucleic acid amplification tests take hours or days, depending on whether retesting is required, and are costly. While results of laboratory-based tests usually take days to reach clinics, currently available rapid tests for chlamydia detection in male urine lack the required sensitivity, the researchers say.1
Helen Lee, PhD, head of the Cambridge research team, says, "Without an effective and rapid testing program for men, we are unlikely to succeed in efforts to control chlamydia infection. This new test is both accurate and swift, allowing men attending the clinics to be tested and treated on site in one visit."
References
- Nadala E-C, Goh BT, Magbanua J-P, et al. Performance evaluation of a new rapid urine test for chlamydia in men: Prospective cohort study. Br Med J 2009; 339. DOI:10.1136/ bmj.b2655.
- Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2007. Atlanta: Department of Health and Human Services; December 2008.
- Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS). Atlanta: Department of Health and Human Services, Centers for Disease Control and Prevention; 2003. Available at www.cdc.gov/ncipc/wisqars.
- Wisniewski C, White J, Michel CE, et al. Optimal collection of first-void urine for detection of Chlamydia trachomatis infection in men. J Clin Microbiol 2008; 46:1,466-1,469.
Put CDC guidance on chlamydia into practice The Centers for Disease Control and Prevention (CDC) recommends yearly chlamydia testing of all sexually active women age 25 or younger; older women with risk factors for chlamydial infections, such as those who have a new sex partner or multiple sex partners, and all pregnant women. An appropriate sexual risk assessment always should be conducted by a health care provider and might indicate more frequent screening for some women, the CDC advises.1 Women who are treated for chlamydia should be retested for infection about three months after treatment, advises the CDC.2 It also is recommended that where possible, expedited partner therapy be implemented, whereby antibiotic therapy is delivered by heterosexual patients to their partners if other strategies for reaching and treating partners are not likely to succeed. References
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