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Testing for Chlamydia trachomatis: self-test or laboratory-based diagnosis?

©FFPRHC J Fam Plann Reprod Health Care 2007: 33(4) Background Increasing publicity about sexually transmitted infections (STIs), in particular about screening young people for Chlamydia trachomatis (CT), is accompanied by some confusion about the various types of tests available including those done outside the usual health care settings (Box 1). At the present time, nucleic acid amplification tests (NAATs) are considered to be the most sensitive and specific tests available for CT testing and are considered to be the ‘gold standard’. In the UK, the Department of Health (DH) has provided funding for all National Health Service (NHS) laboratories to adopt these tests and the National Chlamydia Screening Programme (NCSP) stipulates that screening must be carried out using NAATs. The introduction of these tests has indeed facilitated screening by enabling the use of non-invasive samples (i.e. urine and self-taken vaginal swabs). However, in addition to these laboratory-based assays, there is debate about the role of more rapid tests and their suitability for home use.