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

Jill S. Huppert, Elizabeth Hesse, Grace Kim, Michael Kim, Patricia Agreda, Nicole Quinn, Charlotte A Gaydos

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)514-519
Number of pages6
JournalSexually Transmitted Infections
Volume86
Issue number7
DOIs
StatePublished - Dec 2010

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Point-of-Care Systems
Self Care
Vulnerable Populations
Pruritus
Surgical Instruments
African Americans

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

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Adolescent women can perform a point-of-care test for trichomoniasis as accurately as clinicians. / Huppert, Jill S.; Hesse, Elizabeth; Kim, Grace; Kim, Michael; Agreda, Patricia; Quinn, Nicole; Gaydos, Charlotte A.

In: Sexually Transmitted Infections, Vol. 86, No. 7, 12.2010, p. 514-519.

Research output: Contribution to journalArticle

Huppert, Jill S. ; Hesse, Elizabeth ; Kim, Grace ; Kim, Michael ; Agreda, Patricia ; Quinn, Nicole ; Gaydos, Charlotte A. / Adolescent women can perform a point-of-care test for trichomoniasis as accurately as clinicians. In: Sexually Transmitted Infections. 2010 ; Vol. 86, No. 7. pp. 514-519.
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title = "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.",
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AU - Quinn, Nicole

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AB - 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.

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