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.
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.
Authors: William C Miller; Heidi Swygard; Marcia M Hobbs; Carol A Ford; Mark S Handcock; Martina Morris; John L Schmitz; Myron S Cohen; Kathleen Mullan Harris; J Richard Udry Journal: Sex Transm Dis Date: 2005-10 Impact factor: 2.830
Authors: Julius Schachter; Max A Chernesky; Dean E Willis; Paul M Fine; David H Martin; Deanna Fuller; Jeanne A Jordan; William Janda; Edward W Hook Journal: Sex Transm Dis Date: 2005-12 Impact factor: 2.830
Authors: Janet S St Lawrence; Wen-Hung Kuo; Matthew Hogben; Daniel E Montaño; Danuta Kasprzyk; William R Phillips Journal: Soc Sci Med Date: 2004-09 Impact factor: 4.634
Authors: Jill S Huppert; Elizabeth A Hesse; Marianne Claire Bernard; Justin R Bates; Charlotte A Gaydos; Jessica A Kahn Journal: J Adolesc Health Date: 2012-03-21 Impact factor: 5.012
Authors: Jill S Huppert; Elizabeth A Hesse; Molly A Bernard; Yang Xiao; Bin Huang; Charlotte A Gaydos; Jessica A Kahn Journal: Sex Transm Infect Date: 2011-07-27 Impact factor: 3.519
Authors: Charlotte A Gaydos; Jeffrey D Klausner; Nitika Pant Pai; Helen Kelly; Cordelia Coltart; Rosanna W Peeling Journal: Sex Transm Infect Date: 2017-07-06 Impact factor: 3.519
Authors: Erik Munson; David Wenten; Paula Phipps; Roger Gremminger; Mary Kay Schuknecht; Maureen Napierala; Deb Hamer; Robin Olson; Ronald F Schell; Jeanne E Hryciuk Journal: J Clin Microbiol Date: 2013-04-03 Impact factor: 5.948