14 Jun Question Many of the modules i
Question
Many of the modules in this course use case studies to allow you to apply the theory covered in the module as well as in the text.
You are to write a 2-3 page paper, in APA formatting, which addresses the case questions. Your answer must be supplemented with research from your book, CDC, NIH, and other quality sources to determine answers and solutions. Note: A minimum of two references should be used that support your responses in your paper. This is a paper, so your answer should not be numbered, but rather you should use titles and subtitles.
Case Study Testing for Chlamydia
Chlamydia trachomatis is a prevalent sexually transmitted organism, and is known to cause serious
complications in women, such as pelvic inflammatory disease, infertility, and ectopic pregnancy. The
Centers for Disease Control (CDC) therefore recommends annual screening for all sexually active women
age 15-25 (among this group the prevalence rate is estimated to be 25%) (Chernesky, 1999). The value
of screening men has not been determined, as men have no sequelae and often have no symptoms of
infection. Public health agencies are reluctant therefore to direct money and other resources toward
screening of males, even though it has been considered that asymptomatic men may be an important
reservoir of chlamydial infection, and the source of infection and complications for women. Overall
prevalence for Chlamydia in men in the United States is 7% (Shillinger et al, 2005). The U.S. Department
of Labor produced statistics related to U.S. prevalence of Chlamydia for men in the 16-24 age group in
2003 (Figure 1).
Job Training Program by state of residence: United States and outlying areas, 2003
*Fewer than 100 men residing in these states and entering the National Job Training Program were
screened for chlamydia in 2003. Note: The overall chlamydia prevalence among male students entering the National Job Training Program for the period July-December 2003 was 8.0%. SOURCE: U.S.
Department of Labor
The technology for Chlamydia screening using urine samples became available in 1999. Chernesky and
colleagues (1999) compared three point of care urine tests and the commonly known leukocyte dipstick
test (used for urinalysis) against a reference standard of positivity determined by ligase chain reaction
(LCR) assay (LCx), and a confirmed Chlamydiazyme assay (EIA). The LCR and EIA are the previously
known “gold standard” methods of Chlamydia testing using urethral (men) or endocervical (women)
specimens. Results with sensitivities and specificities appear in Table 1 below:
TABLE 1. Diagnostic performances of three rapid tests and LE dipstick assay compared to those of two
reference standards for detection of C. trachomatis with FVU specimens from men.
Rapid test Standard % Sensitivity % Specificity
Testpack Chlamydia (Abbott) EIAa
LCRc
76.4 (42/55)b
70.9 (44/62)
93.2 (68/73)
95.5 (63/66)
Surecell Chlamydia (Kodak) EIA
LCR
67.3 (37/55)
62.9 (39/62)
97.3 (71/73)
100 (66/66)
Clearview Chlamydia (Unipath) EIA
LCR
76.4 (42/55)
67.7 (42/62)
95.9 (70/73)
95.5 (63/66)
LE dipstick (Boehringer) EIA
LCR
88.6 (39/44)
87.5 (42/48)
89.0 (65/73)
92.4 (61/66)
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