Review Article

A Systematic Review of Point of Care Testing for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis

Table 1

Performance evaluations of point of care tests for Chlamydia trachomatis from 2010 to 2015.

Study authors and year LocationTest used Sample typeReference testSample size and populationSensitivity (95% CI)Specificity
(95% CI)
Positive predictive value (95% CI) or LR+Negative predictive value
(95% CI) or LR−

Bartelsman et al. 2015 [19]Amsterdam, NetherlandsGram stained urethral smear (2008-2009: including asymptomatic)Urethral swabAPTIMA CT assay (Hologic, USA)7,185 “high risk” men at STI clinic, both symptomatic and asymptomatic83.8% (81.2–86.1%)74.1% (73.0–75.2%)31.7% (29.8–33.6%)97.0% (96.4%–97.4%)

Bartelsman et al. 2015 [19]Amsterdam, NetherlandsGram stained urethral smear (2010-2011: only symptomatic)Urethral swabAPTIMA CT assay (Hologic, USA)18,852 “high risk,” symptomatic men at STI clinic 91.0% (89.5–92.3%) 53.1% (51.8–54.4%)35.6% (34.1–37.1%)95.4%
(94.6–96.1%)

Pond et al. 2015 [20]London, UKGram stained urethral smearUrethral swabBD Viper Qx System (BD, USA)208 symptomatic male patients
(mean age 31 years) without NG at genitourinary medicine clinic
93.7%
(67.7–99.6%)
N/A16.1%
(9.6–25.5%)
99.1%
(94.5–99.9%)

Gaydos et al. 2013 [21]USACepheid GeneXpert
CT/NG
(nucleic acid amplification test (NAAT))
Vaginal swab (self-collected)Aptima Combo 2 assay (Hologic, USA) & ProbeTec ET System (BD, USA)1,722 sexually active females, symptomatic and asymptomatic, at OB-GYN, STD, teen, public health, or family planning clinics98.7% (93.1–100%)99.4% (98.9–99.7%)88.6%99.9%

Gaydos et al. 2013 [21]USACepheid GeneXpert CT/NG
(NAAT)
Endocervical swabAptima Combo 2 assay (Hologic, USA) & ProbeTec ET System (BD, USA)1,722 sexually active females, symptomatic and asymptomatic, at OB-GYN, STD, teen, public health, or family planning clinics97.4% (91.0–99.7)99.6% (99.1–99.8%)91.6%99.9%

Gaydos et al. 2013 [21]USACepheid GeneXpert CT/NG
(NAAT)
Urine Aptima Combo 2 assay (Hologic, USA) & ProbeTec ET System (BD, USA)1,722 sexually active females, symptomatic and asymptomatic, at OB-GYN, STD, teen, public health, or family planning clinics97.6% (91.5–99.7%)99.8% (99.5–100%)96.4%99.9%

Gaydos et al. 2013 [21]USACepheid GeneXpert CT/NG
(NAAT)
Urine Aptima Combo 2 assay (Hologic, USA) & ProbeTec ET System (BD, USA)1,387 sexually active males, symptomatic and asymptomatic, at OB-GYN, STD, teen, public health, or family planning clinics97.5% (91.4–99.7%)99.9% (99.6–100%)98.7%99.8%

Ham et al. 2015 [22]South KoreaaQcare Chlamydia TRF kit
(lateral flow immunoassay (LFIA))
Endocervical and urethral swabs, urine overall resultsAccuPower CT & NG Real-Time PCR Kit (Bioneer, Korea)340 women and 101 men, age 20–80, who visited a hospital for the evaluation of STD symptoms93.0% (88.0–96.3%)96.3% (94.6–97.5%)89.8% (85.0–93.0%)97.5% (95.8–98.7%)

Ham et al. 2015 [22]South KoreaaQcare Chlamydia TRF kit
(LFIA)
Endocervical and urethral swabsAccuPower CT & NG Real-Time PCR Kit (Bioneer, Korea)8 urethral swabs and 340 endocervical swabs from women and men, age 20–80, who visited a hospital for the evaluation of STD symptoms93.8% (88.6–97.0%)96.8% (94.8–98.1%)91.9%
Calculated by review authors
97.6%
Calculated by review authors

Ham et al. 2015 [22]South KoreaaQcare Chlamydia TRF kit
(LFIA)
Urine AccuPower CT & NG Real-Time PCR Kit (Bioneer, Korea)93 men and women, age 20–80, who visited a hospital for the evaluation of STD symptoms88.2% (67.4–97.7%)94.7% (90.1–96.9%)79.0%
Calculated by review authors
97.3%
Calculated by review authors

Hurly et al. 2014 [23]Port Vila, VanuatuChlamydia Rapid Test, Diagnostics for the Real World
(Signal Amplification System (SAS))
UrineCOBAS TaqMan Analyzer CT assay (Roche, USA)156 men, age 18+, at reproductive health clinic41.4% (23.5–61.1%)89.0% (82.2–93.8%)46.2%
Calculated by review authors
86.9%
Calculated by review authors

Hurly et al. 2014 [23]Port Vila, VanuatuChlamydia Rapid Test, Diagnostics for the Real World
(SAS)
Vaginal swab (self-collected)COBAS TaqMan Analyzer CT assay (Roche, USA)223 women, age 18+, at reproductive health clinic, pregnant women not excluded74.2% (61.5–84.5%)95.7% (91.3–98.2%)86.8%
Calculated by review authors
90.6%
Calculated by review authors

van der Helm et al. 2012 [24]Paramaribo, SurinameChlamydia Rapid Test, Diagnostics for the Real World
(SAS)
Vaginal swab (nurse-collected)Aptima CT assay (Hologic, USA)912 women (median age 30 years) at either STI clinic or sexual health clinic41.2% (31.9–50.9%)96.4% (95.0–97.5%)59.2% (47.5–70.1%)92.9% (91.0–94.5%)

van der Helm et al. 2012 [24]Paramaribo, SurinameChlamydia Rapid Test, Diagnostics for the Real World
(SAS)
Vaginal swab (nurse-collected)Aptima CT assay (Hologic, USA)159 women seeking STI care at STI clinic, “high risk”39.4% (24.0–56.6%) 94.4% (89.3–97.5%)65.0% (42.7–83.2%)85.6% (79.0–90.7%)

van der Helm et al. 2012 [24]Paramaribo, SurinameChlamydia Rapid Test, Diagnostics for the Real World
(SAS)
Vaginal swab (nurse-collected)Aptima CT assay (Hologic, USA)753 women at sexual health/family planning clinic, “low risk”42.0% (30.8–53.9%) 96.8% (95.3–97.9%)56.9% (43.1–69.9%)94.3% (92.4–95.8%)

Hurly et al. 2014 [23]Port Vila, VanuatuACON Chlamydia Rapid Test Device
(immunoassay)
UrineCOBAS TaqMan Analyzer CT assay (Roche, USA)133 men, age 18+, at reproductive health clinic 43.8% (19.8–70.1%)98.3% (93.9–99.8%)77.8% Calculated by review authors92.7%
Calculated by review authors

Hurly et al. 2014 [23]Port Vila, VanuatuACON Chlamydia Rapid Test Device
(immunoassay)
Vaginal swab (self-collected)COBAS TaqMan Analyzer CT assay (Roche, USA)75 women, age 18+, at reproductive health clinic, pregnant women not excluded 66.7% (22.3–95.7%)91.3%
(82.0–96.7%)
40.0%
Calculated by review authors
96.9%
Calculated by review authors

Nuñez-Forero et al. 2016 [25]Bogota, ColombiaACON Chlamydia Rapid Test Device
(immunoassay)
Endocervical swabCOBAS AMPLICOR Analyzer CT/NG assay (Roche, USA)229 sexually active females, age 14–49, w/lower UTI symptoms (pregnant women excluded)22.7% (2.9–42.5%)100% (99.7–100%)Not quantifiable (LR+)0.8 (LR−)

Nuñez-Forero et al. 2016 [25]Bogota, ColombiaACON CT/NG Duo test
(immunoassay)
Endocervical swabCOBAS AMPLICOR Analyzer CT/NG assay (Roche, USA)491 sexually active females, age 14–49, w/lower UTI symptoms (pregnant women excluded)30.5% (17.9–43.1%)99.8% (99.2–100%)131.8 (LR+)0.7 (LR−)

Nuñez-Forero et al. 2016 [25]Bogota, ColombiaQuickVue Chlamydia Rapid Test
(immunoassay)
Endocervical swabCOBAS AMPLICOR Analyzer CT/NG assay (Roche, USA)664 sexually active females, age 14–49, w/lower UTI symptoms (pregnant women excluded)37.7% (23.7–51.7%)99.4% (98.6–100%)57.6 (LR+)0.6 (LR−)

Van Dommelen et al. 2010 [26]Maastricht, NetherlandsQuickVue Chlamydia Rapid Test
(immunoassay)
Vaginal swab (self-collected)COBAS AMPLICOR Analyzer CT/NG assay (Roche, USA)763 females, age 16+, at STI clinic25.0% (15.7–34.3%)99.7% (99.3–100%)91.3%91.5%

Pond et al. 2015 [20]London, UKAutomated Urine Flow Cytometry of first void urineUrine BD Viper Qx System (BD, USA)208 symptomatic male patients
(mean age 31 years) without NG at genitourinary
medicine clinic
93.7%
(67.7–99.6%)
N/A28.3%
(17.1–42.5%)
99.3%
(95.8–99.9%)

Van Dommelen et al. 2010 [26]Maastricht, NetherlandsHandilab-C
(enzyme detection)
Vaginal swab (self-collected)COBAS AMPLICOR Analyzer CT/NG assay (Roche, USA)735 females, age 16+, at STI clinic22.5% (13.0–31.7%)88.9% (86.4–91.3%)90.4%4.8%

Van Dommelen et al. 2010 [26]Maastricht, NetherlandsBiorapid Chlamydia Ag test
(antigen detection)
Vaginal swab (self-collected)COBAS AMPLICOR Analyzer CT/NG assay (Roche, USA)763 females, age 16+, at STI clinic17.1% (8.9–25.2%)93.7% (91.9–95.5%)24.6%90.4%