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.
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