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Low Sensitivity of the Leukocyte Esterase Test (LET) in Detecting Chlamydia trachomatis Infections in Asymptomatic Men Entering a County Jail

Division of STD Prevention, State Laboratory Institute, Massachusetts Department of Public Health, Boston; Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester; Division of STD Prevention, State Laboratory Institute, 305 South St., Boston, MA 02130; sylvie.ratelle{at}state.ma.us

Meeta S. Nguyen, MD, MPH

Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester

Yuren Tang, MD, MPH

Michael Whelan, BS, MS

Paul Etkind, DrPH

Division of STD Prevention, State Laboratory Institute, Massachusetts Department of Public Health, Boston

Thomas Lincoln, MD

Hampden County Correctional Center, Ludlow, Massachusetts; Department of Medicine, Baystate Medical Center, Springfield, Massachusetts

William Dumas

Division of STD Prevention, State Laboratory Institute, Massachusetts Department of Public Health, Boston

Objectives: To determine the test performance characteristics of the leukocyte esterase test (LET) in detecting Chlamydia trachomatis (CT) infections in asymptomatic men entering a county jail. Methods: First-void urine of 2,176 men was simultaneously tested for urethral inflammation by the LET and for CT by the ligase chain reaction (LCR). Results: Using the LCR as reference standard, the sensitivity, specificity, and positive and negative predictive values of the LET with confidence intervals were 6.1% (2.7, 12.7), 98.5% (97.9, 99.0), 18.4% (8.3, 34.9), and 95.1% (94.0, 95.9), respectively. Conclusion: The LET lacks sensitivity in detecting asymptomatic chlamydial infection among men entering a correctional facility. Alternatives should be sought as cost-saving strategies.

Journal of Correctional Health Care, Vol. 10, No. 2, 217-226 (2004)
DOI: 10.1177/107834580301000206


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