BACKGROUND: Screening for sexually transmitted infections (STIs) in the emergency department (ED) is limited by the need for pelvic examination. It has been suggested that using self-administered vaginal swabs (SAVS) for this purpose may save time and resources and may be more comfortable for patients. OBJECTIVES: The objective was to test the feasibility of using SAVS for STI screening in the ED. METHODS: This was a prospective study of female ED patients 18 to 55 years old who consented to physician-assisted cervical swab (PACS) and SAVS in two urban teaching hospitals. The ED personnel offered the test to all patients, whether or not a pelvic examination was indicated, based on their chief complaint. All specimens were analyzed by polymerase chain reaction (PCR) assay. Data are presented as mean +/- standard deviation (SD). Categorical data are presented as percentages with 95% confidence intervals (CIs). Patients with a positive test result for Chlamydia trachomatis and/or Neisseria gonorrhoeae were considered positive for STI. PACS were used as the criterion standard. RESULTS: One-hundred sixty-two subjects were enrolled from July 2006 to July 2007 (mean [+/-SD] age = 32 [+/-10] years). Eighty-one percent of patients had a genitourinary symptom (most common: vaginal bleeding/spotting). SAVS had a sensitivity of 91% (95% CI = 60% to 99%), specificity of 99% (95% CI = 95% to 99%), positive likelihood ratio of 91, and negative likelihood ratio of 0.09 in diagnosing STIs. None of the patients reported difficulty or discomfort using this technique. CONCLUSIONS: Self-administered vaginal swabs can be utilized as a feasible alternative to PACS for STI screening in the ED.
BACKGROUND: Screening for sexually transmitted infections (STIs) in the emergency department (ED) is limited by the need for pelvic examination. It has been suggested that using self-administered vaginal swabs (SAVS) for this purpose may save time and resources and may be more comfortable for patients. OBJECTIVES: The objective was to test the feasibility of using SAVS for STI screening in the ED. METHODS: This was a prospective study of female ED patients 18 to 55 years old who consented to physician-assisted cervical swab (PACS) and SAVS in two urban teaching hospitals. The ED personnel offered the test to all patients, whether or not a pelvic examination was indicated, based on their chief complaint. All specimens were analyzed by polymerase chain reaction (PCR) assay. Data are presented as mean +/- standard deviation (SD). Categorical data are presented as percentages with 95% confidence intervals (CIs). Patients with a positive test result for Chlamydia trachomatis and/or Neisseria gonorrhoeae were considered positive for STI. PACS were used as the criterion standard. RESULTS: One-hundred sixty-two subjects were enrolled from July 2006 to July 2007 (mean [+/-SD] age = 32 [+/-10] years). Eighty-one percent of patients had a genitourinary symptom (most common: vaginal bleeding/spotting). SAVS had a sensitivity of 91% (95% CI = 60% to 99%), specificity of 99% (95% CI = 95% to 99%), positive likelihood ratio of 91, and negative likelihood ratio of 0.09 in diagnosing STIs. None of the patients reported difficulty or discomfort using this technique. CONCLUSIONS: Self-administered vaginal swabs can be utilized as a feasible alternative to PACS for STI screening in the ED.
Authors: Rameet H Singh; Jonathan M Zenilman; Kathryn M Brown; Tessa Madden; Charlotte Gaydos; Khalil G Ghanem Journal: Sex Transm Infect Date: 2012-09-27 Impact factor: 3.519
Authors: Andrew Vallely; Andrew Page; Shannon Dias; Peter Siba; Tony Lupiwa; Greg Law; John Millan; David P Wilson; John M Murray; Michael Toole; John M Kaldor Journal: PLoS One Date: 2010-12-23 Impact factor: 3.240
Authors: Carole Lunny; Darlene Taylor; Linda Hoang; Tom Wong; Mark Gilbert; Richard Lester; Mel Krajden; Gina Ogilvie Journal: PLoS One Date: 2015-07-13 Impact factor: 3.240