Adolescent women can perform a point-of-care test for trichomoniasis as accurately as clinicians

Abstract

Objectives To compare the accuracy (ie, correlation, sensitivity, specificity) of self-performed point-of-care (POC) tests with clinician-performed tests for trichomoniasis in adolescent women. Methods Sexually experienced women aged 14–22 years (n=209) collected a vaginal swab and performed a POC test for trichomoniasis. Using a speculum, the clinician obtained vaginal swabs that were tested for trichomoniasis using the POC test, wet mount, culture and transcription-mediated amplification (TMA) using standard and alternative primers. Self and clinician results were compared with true positives, defined as either culture-positive or TMA-positive with both sets of primers. Results Participants’ mean age was 17.8 years; 87% were African-American; 74% reported vaginal itching or discharge and 51 (24%) had trichomoniasis. Over 99% correctly performed and interpreted her self-test. Self and clinician POC tests were highly correlated (95.7% agreement, κ 0.87). Compared with true positives, the sensitivity of the self-POC test was 78% (CI 65% to 89%), similar to that of the clinician-POC test (84%, CI 71% to 93%) and culture (82%, CI 69% to 92%), and significantly better than wet mount (39%, CI 26% to 54%). The specificity of the self-POC test was 99% (CI 96% to 100%), similar to that of the clinician-POC test (100%, CI 98% to 100%). The sensitivity of the self-POC test was not affected by vaginal symptoms or other variables. Conclusions Young women performing a self-POC test detected as many trichomoniasis infections as clinician-POC tests or culture, twice as many as wet mount and slightly fewer than an amplified test. Incorporating self-obtained or self-performed POC tests into routine practice could effectively increase the identification and treatment of trichomoniasis in this vulnerable population.

Prevalence of Trichomonas vaginalis in Pregnant Women in Zanjan, Northwest of Iran

“…In both methods, in vitro culture and direct microscopic examination, all 33 samples were positive. Although direct method has lower sensitivity in comparison with other methods, including culture (14), the results are not consistent among different laboratories that may be affected by different factors such as the time of microscopic observation and possible intervals between sampling and observation times.…”

Female Epidemiology of Transcription-Mediated Amplification-Based Trichomonas vaginalis Detection in a Metropolitan Setting with a High Prevalence of Sexually Transmitted Infection

“…Recent data indicate increased sensitivity of transcription-mediated amplification (TMA)-based detection of Trichomonas vaginalis compared to that of wet mount microscopy (12,18,19,22), culture (12,22), nucleic acid hybridization (1), and antigen detection (12). In spite of trichomoniasis largely presenting as vulvovaginitis, T. vaginalis analyte-specific reagent (ASR)-derived data describe the value of endocervical samplings for molecular T. vaginalis detection (19,22,24).…”

Three-Year History of Transcription-Mediated Amplification-Based Trichomonas vaginalis Analyte-Specific Reagent Testing in a Subacute Care Patient Population

“…Advances in molecular diagnostics specific to T. vaginalis have yielded amplification assays that demonstrate increased sensitivity compared to culture-based (15,25), microscopic (15,24,25), nucleic acid hybridization-based (1), and antigen-based (15) methods. Validation of the transcription-mediated amplification (TMA)-based T. vaginalis analyte-specific reagent (ASR; Gen-Probe, Inc., San Diego, CA) was completed by our laboratory in early 2007 on vaginal (23) and endocervical collections (24).…”