Gaps in sexually transmitted infection (STI) diagnosis hinder effective STI control particularly in low-resource settings where syndromic management is often the standard of care. Rapid and affordable point-of-care (POC) diagnostics for STIs such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are needed. This study evaluated the diagnostic performance of Eazyplex (a point-of-care test (POCT)) to screen CT and NG among sexually active women in Zimbabwe.
We enrolled 220 sexually active women aged 18–35 (median 28 years) years attending a family planning clinic in Zimbabwe. Samples collected from vaginal swabs were tested for CT and NG using Eazyplex, GeneXpert and PRESTO CT/NG. Diagnostic performance metrics (sensitivity, specificity, positive predictive value and negative predictive value) were calculated against GeneXpert, PRESTO CT/NG and a GeneXpert+PRESTO CT/NG combined reference standard. For the combined reference standard, a participant was categorised as having a positive result for CT or NG if either of the two tests yielded a positive result.
Overall, Eazyplex reported high specificity and low sensitivity. CT results demonstrated sensitivities of 60.9%, 76.2% and 64.0% compared with GeneXpert, PRESTO CT/NG and GeneXpert+PRESTO CT/NG combined, respectively. NG results demonstrated sensitivities of 57.1%, 66.7% and 66.7% compared with GeneXpert, PRESTO CT/NG and GeneXpert+PRESTO CT/NG combined, respectively. All results had specificity ≥98.5%.
Eazyplex was highly specific but moderately sensitive in detecting NG and CT. While not suitable as a standalone screening tool, its rapid turnaround gives it potential for use as near POCT in low-resource settings.