Chlamydia testing in the UK.

The statement in the commentary article by Skidmore et al.1 that “in the UK, the Department of Health has provided funding for all National Health Service laboratories to adopt [nucleic acid amplification] tests”, for the detection of Chlamydia trachomatis, seems to be based on treating the terms England and UK as synonymous. While that might be an understandable mistake, it is still a mistake. In 2003, the Department of Health in England provided £810001000 to support laboratories to change from the inaccurate but cheap enzyme-linked immunoassay tests (ELISAs) for C. trachomatis to the accurate but expensive nucleic acid amplification tests (NAATs).2 Four years later, the Chief Medical Officer (CMO) in Wales has taken a similar view that testing platforms for the detection of genital C. trachomatis other than NAATs are suboptimal. Unfortunately, although the CMO estimates that it will only cost £150 000 to extend the use of NAATs across the whole of Wales and states that “service commissioners and providers would be highly vulnerable to criticism if what is now the recognised optimal testing method was not used”, I do not think that any funding has been provided to the laboratories in Wales.3 Here in Mid Wales we are still using an ELISA to detect, as the CMO estimates, 70% of female and 54% of male genital C. trachomatis infection3 and, as I write this letter, we have but 7 weeks to comply with the CMO’s expectation that all individuals tested for chlamydia infection in Wales will be offered the NAAT by 1 December 2007.3