A Population-Specific Optimized GeneXpert Pooling Algorithm for Chlamydia trachomatisand Neisseria gonorrhoeaeTo Reduce Cost of Molecular Sexually Transmitted Infection Screening in Resource-Limited Settings

The sexually transmitted infections (STIs) chlamydia (CT) and gonorrhea (NG) are often asymptomatic in women and undetected by syndromic management, leading to complications such as pelvic inflammatory disease, infertility, and ectopic pregnancy. Molecular testing, such as the GeneXpert CT/NG assay, is highly sensitive, but cost restraints preclude implementation of these technologies in resource-limited settings. Pooled testing is one strategy to reduce the cost per sample, but the extent of savings depends on disease prevalence.