Evaluation of the OSOM
            <i>Trichomonas</i>
            Rapid Test versus Wet Preparation Examination for Detection of
            <i>Trichomonas vaginalis</i>
            Vaginitis in Specimens from Women with a Low Prevalence of Infection

Campbell, Lorraine; Woods, V. Diane; Lloyd, Tracie; Elsayed, Sameer; Church, DL

doi:10.1128/jcm.00671-08

Cited by 77 publications

(43 citation statements)

References 17 publications

(19 reference statements)

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“…This information would be clinically useful when evaluating vaginal discharge and lower genital tract symptoms. Microscopy is the most common method used to diagnose trichomoniasis, but the sensitivity is poor (55%; 35 to 77%) (13)(14)(15)(16). The presence of leukorrhea in the absence of motile trichomonads could potentially be presumed to be cervicitis and empirically treated without further evaluation for Trichomonas.…”

mentioning

confidence: 99%

Correlation of Leukorrhea and Trichomonas vaginalis Infection

2013

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Trichomonas vaginalis is a common sexually transmitted infection (STI) causing vaginitis. Microscopy has poor sensitivity but is used for diagnosis of trichomoniasis in resource-poor settings. We aimed to provide a more reliable diagnosis of trichomoniasis by investigating an association with leukorrhea. Women presenting for evaluation of vaginal discharge, STI exposure, or preventative gynecologic examination were evaluated for Trichomonas infection. Vaginal pH was determined and microscopy was performed by the provider, who recorded the number of polymorphonuclear leukocytes (PMNLs) per epithelial cell and the presence of clue cells, yeast, and/or motile trichomonads. Leukorrhea was defined as greater than one PMNL per epithelial cell. Culture and a nucleic acid amplification test (NAAT) were used to detect T. vaginalis. Patients were evaluated for Chlamydia trachomatis and Neisseria gonorrhoeae using NAATs and bacterial vaginosis using Gram stains. Two hundred ninety-four women were enrolled, and 16% were found to have Trichomonas (46/294). Trichomonas infection was more common in parous non-Hispanic, black women, who reported low rates of contraceptive use (33% versus 17%; P ‫؍‬ 0.02) and a STI history (85% versus 55%; P ‫؍‬ 0.002). These women were more likely to report vaginal discharge (76% versus 59%; P ‫؍‬ 0.02) and have an elevated vaginal pH (87% versus 48%; P < 0.001) and gonorrhea infection (15% versus 4%; P ‫؍‬ 0.002). Leukorrhea was associated with a 4-fold-increased risk of Trichomonas infection. Leukorrhea on microscopy was associated with Trichomonas vaginitis. Patients with leukorrhea should be evaluated with more-sensitive tests for T. vaginalis, preferably NAATs, if microscopy is negative.

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confidence: 99%

Correlation of Leukorrhea and Trichomonas vaginalis Infection

2013

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“…ICT is based on the detection of T.vaginalis antigens rather than the live whole parasite, therefore such false positivity results are likely to occur [9]. ICT, having high levels of sensitivity and specificity, has been recommended by others as a good screening test especially for low prevalence settings like in Sri Lanka [9][10].…”

Section: Discussionmentioning

confidence: 99%

Use of culture and immunochromatographic technique for diagnosis of trichomoniasis in Sri Lanka

et al. 2013

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SummaryAs a majority of the trichomoniasis patients are asymptomatic, laboratory tests are crucial in case detection. The usefulness of culture and immunochromatographic technique (ICT) compared to microscopy for detection of trichomoniasis in Sri Lanka was assessed. Females (16-45 years) from Colombo district were screened for Trichomonas vaginalis using three laboratory tests namely, microscopy of wet smear, Trichomonas liquid culture and ICT (OSOM ® trichomonas rapid test). Trichomoniasis by at least one test being positive was 4.8%. Microscopy, culture and ICT detected 2.8%, 4.2% and 10% cases respectively. Microscopy missed 32% of culture positives. ICT is a simple, practical and reliable alternative to microscopy in laboratory diagnosis of trichomoniasis.

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“…29,30 The sensitivity and specificity has been reported to be 80-94% and greater than 95%, respectively, depending on the comparator. 27,28,34,35 This test requires no instrumentation and provides a result within 30 min and is a suitable alternative to culture or molecular testing. Although these tests are more sensitive than those requiring vaginal wet preparation, false positives might occur, especially in populations with a low prevalence of disease, so consideration should be given to confirming positives in that situation.…”

Section: Point Of Care Tests Level Of Evidence: Iib Bmentioning

confidence: 99%