| Summary: | Conclusions Chlamydia is by far the most commonly reported sexually transmitted infection (STI) in Sweden. It is mandatory to report all new cases to the Swedish Institute for Infectious Disease Control and to the county council's physician in charge of infectious disease control. Chlamydia is transmitted through unprotected sexual contact. Most people infected do not present obvious symptoms. Untreated, chlamydia can lead to permanent lesions and infertility. In women, chlamydia can be diagnosed by analyzing cervical, vaginal, or urine specimens. Women can collect vaginal and urine specimens themselves.1. Urine specimens are somewhat less sensitive (i.e., miss more cases) than vaginal and cervical specimens. Vaginal specimens have the highest sensitivity for diagnosing chlamydia in women.2. Urine, vaginal, and cervical specimens have similar specificity. In other words, they are equally likely to yield a correct, i.e., negative, finding in women who are not infected.3. The scientific evidence is insufficient to compare the diagnostic accuracy of urine specimens alone versus various combinations of specimens, since only one study in the assessment included such a comparison.4. The scientific evidence is insufficient to draw conclusions on the cost-effectiveness of using urine specimens as the only test for establishing a chlamydia diagnosis in women. Too few studies of sufficient quality are available. The total cost of chlamydia testing is influenced mainly by how specimens are taken. Vaginal and urine specimens can be collected by the patient herself. This lowers the cost in comparison to taking cervical specimens, where health professionals must collect the specimen
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