The prevalence of Chlamydia trachomatis among 3,026 asymptomatic males tested on urine with the ligase chain reaction (LCR) was Journal of Correctional Health Care 5.9%. Only 13.7%, 5.6%, and 1.5% of men reported having, respectively, two or more sex partners, a new sex partner, or an STD contact in the last 60 days. Age was an important predictor of infection. Compared to universal testing, screening all men less than 30 years of age and only older men with risk factors identified 90.4% of infections while testing 56.9% of males. Adopting this screening strategy will result in significant savings while identifying the majority of infections.

Objectives: To determine the test performance characteristics of the leukocyte esterase test (LET) in detecting Chlamydia trachomatis (CT) infections in asymptomatic men entering a county jail. Methods: First-void urine of 2,176 men was simultaneously tested for urethral inflammation by the LET and for CT by the ligase chain reaction (LCR). Results: Using the LCR as reference standard, the sensitivity, specificity, and positive and negative predictive values of the LET with confidence intervals were 6.1% (2.7, 12.7), 98.5% (97.9, 99.0), 18.4% (8.3, 34.9), and 95.1% (94.0, 95.9), respectively. Conclusion: The LET lacks sensitivity in detecting asymptomatic chlamydial infection among men entering a correctional facility. Alternatives should be sought as cost-saving strategies.