A comparison of first-void urine, self-administered low vaginal swab, self-inserted tampon, and endocervical swab using PCR tests for the detection of infection with Chlamydia trachomatis

Abstract

Background: Polymerase chain reaction (PCR) tests, AMPLICOR, Roche Diagnostics, were shown to be an acceptable and sensitive method of detecting Chlamydia trachomatis infection. The PCR test's ability to evaluate different specimen types is worth determining, as well as the acceptability to Thai women of the self-collection of samples. Methods: Of the 1011 subjects interviewed, 953/1011 subjects (94.3%) agreed to self-test, 523 were commercial sex workers (CSWs) and 430 were outpatient women (OPW). More than half [570/953 (59.8%)] participated in the four-specimen collection, to be tested by PCR for C. trachomatis. Specimens were collected via first-void urine (FVU), self-administered low vaginal swab (LVS), self-inserted tampon, and endocervical swab (ES). The majority, 906/953 subjects (95.1%), had only three methods of specimen collection, LVS being excluded. Results: The prevalence of positive C. trachomatis detection among the CSWs/ OPW was 17.6/7.2%, 15.6/5.4%, 12.8/4.2%, and 11.6/5.7% using tampons, LVS, FUV, and ES collection methods respectively. Tampons were used to compare results from other specimen types in both groups. Significantly more OPWs were willing to use a tampon for repeat specimen collection (85.1%) than were the CSWs (62.3%). Willingness to use a LVS again was not significant, 75.2% in outpatient women and 74% in CSWs. Conclusions: Tampon and LVS, self-collection methods are acceptable to women in Thailand and are a good alternative method for detection of C. trachomatis.