ATLANTA – Adding a rapid Trichomonas vaginalis test to the adolescent sexually transmitted infection laboratory regimen facilitated on-site diagnosis and treatment at an urban medical center emergency department.
The OSOM rapid trichomonas test provided point of care testing results in 10 minutes, with a sensitivity of 83% and specificity of 99%, Dr. Heather Territo reported in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention. The prevalence of Trichomonas vaginalis approaches 25% in inner-city adolescents. Prior studies have demonstrated an association between Trichomonas vaginalis and cervical neoplasia, enhanced HIV transmission, and pregnancy complications.
Courtesy CDC
The prevalence of Trichomonas vaginalis approaches 25% in inner-city adolescents.
After routine Trichomonas vaginalis testing was implemented at the Women’s and Children’s Hospital of Buffalo, N.Y., in November 2011, 212 females aged 13-20 years were tested in the following year; 13.6% tested positive by rapid test and 15.5% by nucleic acid amplification test (NAAT). In the year before routine testing was implemented, 31 of 234 patients were tested, based on a retrospective chart review. Treatment was administered to 24% and to 7% of patients during the respective study periods, said Dr. Territo of the hospital’s division of emergency medicine.
Additionally, two positive results were found in 20 males tested.
In the emergency department, Trichomonas vaginalis is often diagnosed on the basis of clinical findings; the positive predictive value of this approach is less than 50%. Direct microscopy of vaginal secretions has a sensitivity of about 60%-70%.
The rapid test and the NAAT test results were concordant in 178 of 188 cases (94.6%). Ten of the 33 positive NAAT tests (30%) were negative on the rapid test.
Dr. Territo reported having no relevant financial disclosures.