trachomatisinfection that either went undiagnosed or was not self-reported. Since PID is not a VU6001376 nationally reportable condition in most jurisdictions (whereasC. the most sensitive of the three tests and could be useful in sero-epidemiologic studies designed to assess population-level exposure to CT. == 1.0 Introduction == Interest in the use of antibody testing for surveillance of both urogenital and ocular chlamydia infection has increased in recent years. Long-lived antibody responses provide a measure of cumulative infection and thereby can inform estimates of exposure in a population1,2,3,4,5,6,7. The Pgp3 antigen has been studied extensively as an immunodominant antigen that, as a plasmid encoded protein8, is unique toChlamydia trachomatisand VU6001376 has been a major focus of surveillance studies for both urogenital and ocular infection. Studies evaluating the use of serologic surveillance for population-level exposure to urogenital infection have used ELISA testing almost exclusively2,4,7,9, while studies evaluating the use of sero-surveillance for trachoma have used both multiplex bead array (MBA) and ELISA6,10,11,12,13). Recently, a lateral flow-based rapid test (LFA) to detect antibodies against Pgp3 was developed for use in trachoma-endemic areas14. Studies using sera from trachoma endemic communities have demonstrated good concordance between the MBA, ELISA, and LFA tests and high sensitivity (>90%) and specificity (>95%) for all tests evaluated15. Pelvic inflammatory disease (PID) is a common reproductive health disorder commonly caused byC. trachomatis that if left untreated results in significant adverse reproductive health outcomes including tubal infertility, ectopic pregnancy, and chronic pelvic pain .16,17,18Despite the documented health impacts on women, both routine STI screening among adolescent and young adult (AYA) women to prevent PID19and treatment of PID in clinical settings20,21are subpar. Further, PID is not a reportable condition, so it is difficult to assess the burden of disease at the population level using public health databases and/or link PID diagnoses to historical or currentC. trachomatisinfections to inform the design and evaluation of effective public health strategies. Seroprevalence data may be useful measure the impact of STI prevention programs on reproductive health outcomes in AYA women with symptomatic disease and/or asymptomatic women with unexplained morbidity that may be due toC. trachomatisinfection. We compared the performance of MBA, ELISA, and LFA tests for antibodies against Pgp3 among AYA women with mild-moderate PID. == 2.0 Methods == == 2.1 Ethics Statement == The Johns Hopkins Medicine Institutional Review Board approved the study (trial registration number:NCT01640379). CDC investigators were determined to be non-engaged in the study and did not have access to patient identifying information. == 2.2 Patient Recruitment and Screening == The TECH-N Study is a large randomized controlled clinical trial of a text messaging and community health nursing intervention to Rabbit polyclonal to ADAM17 improve short-term adherence and longitudinal health outcomes for AYA women diagnosed with mild-moderate acute pelvic inflammatory disease (PID) that was conducted between 2012-2017. The design and VU6001376 preliminary outcomes of this study have previously been published22,23,24. Briefly, trained research assistants recruited patients aged 13-25 years with mild-moderate acute PID from outpatient clinics and emergency departments (adult and pediatric) within a large urban academic medical center in Baltimore, Maryland (United States) at the time of PID diagnosis. PID diagnoses were based on the Centers for Disease Control and Prevention guidance for clinical diagnosis (https://www.cdc.gov/std/tg2015/pid.htm). Enrolled participants completed an audio computerized assisted self-interview (ACASI) to collect baseline demographic and sexual and reproductive health information, such as prior STI/PID history. Participants were randomized to either the intervention or control group using a permutated block design25. Participants provided vaginal specimens for STI testing (includingC. trachomatis) as well as blood samples. == 2.3 Laboratory Testing == == 2.3.1 Nucleic Acid Amplification Test (NAAT) == Vaginal swabs were self-collected3utilizing the APTIMA Vaginal Swab Specimen Collection Kit (Hologic Inc., San Diego, CA) and.