Combination of Individual Tests to Improve Diagnostic Accuracy in Chlamidia Trachomatis Detection

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Background and Objectives: Chlamydial infection is the most common asymptomatic infection worldwide. Despite all national programs, strategies and guidelines, chlamydial infection is still the leading infection worldwide, especially in young population. We have tried to summarize the best diagnostic tools for its detection. Materials and Methods: In the study participated 225 sexually active patients who were tested for chlamydial infection at a Institute of Public Health Kragujevac. Results: Combinations of DIF+RT and RT+IgG do not improve diagnostic efficiency when compared to a rapid test that individually had the best parameters. In situations that require high specificity, the recommended combination is RT/IgA, which as a highly specific test has few false positive results, while the combinations of DIF+RT and BT + IgG, although showing a specificity of 100%, have low sensitivity (33.30%), due to which is why we prefer the RT/IgA combination. The combinations DIF+RT, DIF+RT+ IgG and RT+IgG, although with low sensitivity, but highest values of specificity, PPV and NPV shows the highest values of the extended Juden index of 130.30% and highest values of total diagnostic accuracy of 97.00%. Based on the results of the extended Juden index, taking into account PPV and NPV, the RT/IgA combination shows the highest values of 94.60%, as well as the highest values of total diagnostic accuracy of 93.00%. Conclusions: Combining tests:” Two or more positive tests” or “Any test positive” did not improve the diagnostic efficiency compared to a single “Rapid test”.

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