- Tools other than laboratory tests are unreliable
- risk assessment: mixed research findings
- leukocyte esterase dipstick test: at least
as predictive as risk assessment
- Research on affordable reliable tests is ongoing
Several screening tools for determining if asymptomatic women
have an STD have been tested, but none appears very reliable.
One approach is to use a risk assessment tool to screen all
women at a particular site for possible infection. Using this
tool, the provider asks all women demographic and behavioral
questions, such as their recent sexual history, age and marital
status. Studies have tested this approach in prenatal clinics,
screening all women for gonorrhea and chlamydia, whether they
had vaginal discharge or not. A study in rural Tanzania, for
example, correctly found about seven of every 10 women who had
gonorrhea or chlamydia. However, it incorrectly
identified about seven uninfected
women for every one true infection it found.
Leading uninfected people to believe they have an STD can produce
emotional trauma. It may also cause problems between women and
their partners, because it implies that one of them has been
Another screening tool under study is a simple urine test,
the leukocyte esterase dipstick or LED test. Recent studies
in Zaire and Jamaica found that the LED test was at least as
predictive of STD infections as were the questions about risk
factors. The LED test does not require laboratory facilities.
It identifies infection through color charts that correspond
with white blood cells found in urine. This test can be used
in combination with a risk assessment.
Research on affordable, simple and reliable screening tests
to identify gonorrhea and chlamydia among asymptomatic women
is under way.