Clinicians who are reluctant or too busy to perform pelvic examinations to collect cervical swabs for chlamydia screening now have the opportunity to screen females with either urine, which can be collected in many settings, or vaginal swabs collected by the clinician or the patient in clinical settings. Patients fearful of an invasive procedure now can submit urine or a self-collected vaginal swab for screening. Use of self-collected samples for chlamydia testing might eradicate some screening barriers.

Urine testing has facilitated expansion of chlamydia screening programs and has shown to be widely acceptable to patients, healthcare providers and laboratory staff. However, urine testing is not without having disadvantages. Patients could be reluctant to provide a urine specimen due to fear of undisclosed drug testing. Also, urine specimens are unlikely to be feasible for home-based testing, due to restrictive requirements for bulky packaging of moderate volumes of fluid (i.e. 30mL or 1 ounce).

Continued expansion of chlamydia screening likely will rely on far more consistent screening in primary care as well as screening in community-based venues, especially in locations with high prevalence. Potentially, urine specimen collection will be feasible making use of low-cost medical staffing models or trained, non-medical personnel. The next promising option is home collection.

There has been significantly interest recently in the possibility of utilizing samples collected at property for direct mailing to a laboratory for testing, thereby by-passing the clinic all together for routine screening when the individual does not have symptoms. Despite the fact that house collection is not but FDA cleared, the focus of existing investigation has shown that vaginal swabs can be collected at home and sent by way of the U.S. mail to a laboratory for testing13, 16, 21. Several studies have indicated that residence collection is preferred by many to most women16, 21.

In order to obtain clearance from FDA for use of innovative sample sorts so as to facilitate a lot more widely accessible tools for chlamydia screening, far more investigation is required on alternative sample varieties such as SOVS collected at house, rectal swabs, and pharyngeal specimens. Further health services analysis is necessary for improving and implementing the use of urine screening in alternative, community-based settings by non-medical personnel.

The development and improvement of point-of-care tests for chlamydia screening will be necessary to facilitate immediate treatment of infected people before they leave the wellness care setting. Cost effectiveness models and cost comparisons of different approaches to chlamydia screening will be required in order to guide the most judicious use of scarce wellness care resources. Education of both clinicians and people at danger for chlamydia infections will be required in order to eliminate barriers that exist now for routine screening of young girls. Resources and recommendation are required for screening men.

At the moment, the CDC does not recommend a test-of-cure following chlamydia treatment. Even so, simply because incidence studies have demonstrated that prior chlamydia infection increases one’s probability of becoming reinfected30, CDC recommends that previously infected people be rescreened 3 months after treatment, a test of reinfection, for chlamydia or gonorrhea.