They can be considered as new generation non-culture tests as they are highly sensitive, accurate and are critical tools for testing Chlamydia. They amplify and detect Chlamydia specific DNA or RNA sequences (these tests find the genetic material) and are non-invasive as they use urine and vulval swabs. It is suggested not to urinate for two hours and not to wipe the genital area during urination before the test. The only limitation for this test is that it is expensive when compared to other tests. Additional testing after a positive result can be done to improve the accuracy of the diagnosis.

This type of lab testing has been used as the reference standard or is considered as a conventional type of testing but has some problems like being technically demanding, time consuming, with transport and storage problems. The bacteria are allowed to grow in the culture and the results are generated only after 5 to 7 days. The advantages of this type of testing include high sensitivity and specificity, low cost, suitability for use, ability to retain the specimen for future testing. Acceptable specimens for culture include cervix, fallopian tubes, urethra, rectum etc and vaginal discharge, peritoneal fluid are some unacceptable specimens for culture.

These tests were first introduced in the 1980s and antibodies tagged with fluorescein were used to directly detect the antigen. Due to the availability of these tests, screening programs were initiated which are more convenient, reliable and can be done in remote settings without problems related to collection and transport. There has been considerable improvement in the sensitivity of non-culture and automated tests over the years. The results can be obtained within half an hour but have few limitations as they cannot detect a substantial proportion of infection, are not useful in low prevalence populations, require invasive specimen collection and are not clinically practical.

These tests are used for quick testing Chlamydia and use fluoresces in labeled monoclonal antibodies that bind specifically to bacterial antigen in the sample. This test is named as Direct Fluorescence Antibody test as it directly detects the presence of antigen which is attached to a specific antibody unlike all other indirect methods. Inaccurate results from these tests performance could be due to poor antibody quality. These tests are not suitable for day-to-day testing of populations with either low or high prevalence of infection. Research is ongoing in order to improve the performance of these tests. These tests are less sensitive than nucleic acid tests.

These quick tests can detect specific Chlamydia antigens which trigger the immune system to fight against the infection. This test should not be used for rectal specimens because of possible cross-reactions with bacteria present in the stools.

Some ELISA tests use poly-clonal antibody as antigen capture whereas others use monoclonal antibody. It is important to examine the early morning urine for detection and it has been proved through clinical trials that when urine specimens were collected from the patients during the clinical visit, the assay could not detect all the positive cases but when the early morning samples were collected all swab-positive patients were detected.

These tests detect specific deoxyribonucleic acid (DNA) or ribonucleic acid (RNA) sequences of Chlamydia, are accurate but are less sensitive than nucleic acid amplification tests. DNA probe tests detect the genetic material of the bacteria. Main advantage of these tests is the ability to store and transport specimens for about a week in normal conditions before testing, reliable performance characteristics and simple to use. The latest nucleic acid probe test, introduced by Gen probe can detect Chlamydia infection along with other infections. In this technique, the labelled DNA, RNA hybrids are separated from the non-hybridized ones and light is emitted by the hybrids confirming a positive result.

Point-of-care tests for Chlamydia include solid-phase enzyme-linked immunoassay and solid-phase optical immunoassay. Single tests or a limited number of tests are performed in this group of testing and patients can expect the results in 30 minutes and the testing is not complicated. This type of testing is usually preferred when the results are required immediately and are usually done in doctor’s offices, small clinics and hospitals and other settings. These tests allow for same day treatment of infection and use potential techniques for detection of infection. Point-of-care tests decrease the transmission of Chlamydia infection from individuals who were left untreated from this bacterial infection. 

These tests recognize markers from Chlamydia in specimens which are self-collected vaginal swabs and results can be produced within 30 minutes. These tests are effective, quick diagnostic and screening tools for Chlamydia infection in women. The main advantage of availability of results within half an hour facilitates immediate treatment and further preventing and reducing the risk of recurrent infection and transmission to others. This method of testing can be used as an alternative to the highly efficient NAATs in screening program, as it is reliable, simple and provides results within a short span of time. The only obstacles with this type of testing are economic constraints, instrument dependent rapid tests.

These tests can be used but have a limited value, as any previous infection produces antibodies which cannot be separated from the antibodies generated in a current infection. To improve the reliability of serological tests for Chlamydia, several techniques like immune-blot analysis, micro immuno-fluorescence titration, and immunoassay are used. Serological tests for Chlamydia can never replace other direct tests but can be useful in certain situations when a patient had previous infections. These tests help in the determination of antibodies to Chlamydia antigens. In patients, suffering from chronic infections, it is difficult to detect Chlamydia infection through direct methods, in such cases serological tests can be useful and a positive serological test may be the only indication for infection.