Leucocyte esterase dip-stick test as a point-of-care diagnostic for urogenital chlamydia in male patients: A multi-center evaluation in two STI outpatient clinics in Paramaribo and Amsterdam

Autor: Jannie J. van der Helm, Henry J. C. de Vries, M Bartelsman, Maarten F. Schim van der Loeff, Leslie O. A. Sabajo
Přispěvatelé: Dermatology, Infectious diseases, Other departments
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Adult
Male
medicine.medical_specialty
Point-of-care testing
Sexually Transmitted Diseases
Chlamydia trachomatis
medicine.disease_cause
Ambulatory Care Facilities
Sensitivity and Specificity
lcsh:Infectious and parasitic diseases
Young Adult
03 medical and health sciences
Sensitivity
0302 clinical medicine
Internal medicine
Prevalence
medicine
Humans
lcsh:RC109-216
Urethritis
030212 general & internal medicine
Chlamydia
Young adult
Point-of-care test
Netherlands
Suriname
030505 public health
Leucocyte esterase test
business.industry
Incidence (epidemiology)
Nucleic acid amplification technique
Chlamydia Infections
medicine.disease
Infectious Diseases
Point-of-Care Testing
Immunology
Tropical medicine
Specificity
0305 other medical science
business
Carboxylic Ester Hydrolases
Nucleic Acid Amplification Techniques
Research Article
Zdroj: BMC infectious diseases, 16(1). BioMed Central
BMC Infectious Diseases
BMC Infectious Diseases, Vol 16, Iss 1, Pp 1-8 (2016)
ISSN: 1471-2334
Popis: Background Point-of-care (POC) tests are an important strategy to address the epidemic of sexually transmitted infections (STIs). The leucocyte esterase test (LET) can be used as a POC test for chlamydia. The aim of this study was to determine the diagnostic accuracy of the LET to detect urogenital chlamydia among men at STI clinics in Paramaribo, Suriname and Amsterdam, the Netherlands. Methods Recruitment of patients took place in 2008–2010 in Suriname and in 2009–2010 in the Netherlands. Urine of patients was examined with the LET. The reference test was a nucleic acid amplification test (NAAT). Results We included 412 patients in Suriname and 645 in the Netherlands. Prevalence of chlamydia in Suriname and the Netherlands was respectively 22.8 and 13.6 %. The sensitivity of the LET was 92.6 % (95 % CI = 85.3–97.0) and 77.3 % (95 % CI = 67.1–85.5) respectively, the specificity was 38.1 % (95 % CI = 32.7–43.6 %) and 58.1 % (95 % CI = 53.9–62.3) respectively. The positive predictive value was 30.6 % (95 % CI = 27.3–36.4) and 22.6 % (95 % CI = 18.0–27.7) respectively and the negative predictive value was 94.5 % (95 % CI = 89.1–97.8) and 94.2 % (95 % CI = 91.1–96.4) respectively. The kappa was respectively 0.179 and 0.176. Conclusions To diagnose urogenital chlamydia in men the LET performs poorly. It has a high negative but low positive predictive value. If the LET result is negative, chlamydia is accurately excluded, yet a positive result has a low predictive value. Whether the advantages of direct management based on LET outweigh the disadvantages of overtreatment is a subject for further studies.
Databáze: OpenAIRE
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