Programs should work with laboratories to determine the best test to be used for the population being screened, in light of the resources available. Using laboratory tests with high sensitivity and specificity, especially in relation to local prevalence rates, is vital to ensuring that all infections are detected and treated.

Programs and laboratories must evaluate the available tests, taking into account the following factors: sensitivity, specificity and predictive values, ease of use in the field, ability to use the test on multiple specimen types, storage and transport requirements, ease of use in the laboratory, volume and through-put, and cost. Analyzing all of these factors will help programs and laboratories determine the most appropriate laboratory test to be used in a project area.

The following resources are provided to assist health professionals in identifying "best practices" as it relates to laboratory testing technology and accompanying quality assurance activities.

CDC Screening Tests To Detect Chlamydia trachomatis and Neisseria gonorrhoeae Infections Guidelines 2002
http://www.cdc.gov/STD/LabGuidelines/default.htm
Evidence-based guidelines developed by CDC. The site is intended to assist laboratorians, clinicians, and managers to choose among the multiple available tests, establish standard operating procedures for collecting and processing specimens, interpret test results for laboratory reporting, and counsel and treat patients.

National Chlamydia Laboratory Committee (NCLC)
http://www.aphl.org/programs/infectious_diseases/std/Pages/default.aspx
The National Chlamydia Laboratory Committee (NCLC) was created in 1995 by the Association of Public Health Laboratories (APHL) in conjunction with the Centers for Disease Control and Prevention (CDC). This site includes recommendations regarding chlamydia screening tests and their applications.

Sexually Transmitted Diseases Diagnostic Initiative
http://www.who.int/std_diagnostics
The Sexually Transmitted Diseases Diagnostics Initiative (SDI) aims to promote the development, evaluation and application of tests for sexually transmitted infections (STI) that are appropriate for use in primary health care settings in developing countries. It provides reports on the latest research and advances in the field of STD diagnostics, as well as training manuals and guidelines, conference information, newsletters and articles.

Gonococcal Isolate Surveillance Project (GISP)
http://www.cdc.gov/std/gisp
Centers for Disease Control and Prevention, Division of STDÕs site for information on the GISP sentinel surveillance system including protocols, research activities, participating laboratories, sentinel sites, data elements and the latest information about anti-microbial resistant strains of Neisseria gonorrhoeae.

CLIA - Clinical Laboratory Improvement Amendments
http://www.fda.gov/cdrh/clia
The Clinical Laboratory Improvement Amendments (CLIA), which were passed by Congress in 1988, establish quality standards for laboratory testing nationwide to ensure the accuracy, reliability and timeliness of patient test results regardless of where the test is performed. This site includes a comprehensive listing of CLIA Quality Standards Guidelines and amendments.

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