Background The availability of sensitive point-of-care tests for Trichomonas vaginalis (TV) in emergency rooms (ER) is important to facilitate immediate diagnosis and treatment. We evaluated the use of the OSOM® Trichomonas Rapid Test, an FDA-approved immunochromatographic capillary flow assay, among female patients in an ER located in the southeastern United States.
Methods The University of North Carolina Hospitals located in Chapel Hill, North Carolina, US replaced wet mount microscopy (WM) for vaginal TV detection with the OSOM® Trichomonas Rapid Test (Genzyme Corporation, US) in October 2011. We analysed 10 months of data for women evaluated in the ER with the rapid test, and compared the positivity rate with a similar 10-month period determined by WM. We assessed characteristics of women identified with trichomoniasis using the rapid test, and the proportion who received appropriate therapy.
Results Over the study period, 1533 female patients were tested for TV using the rapid test, of which 539 (35.2%) were Black, with a median age of 28 years (range 6–82 years). The TV positivity rate based on the rapid test was 5.6% (86/1533), compared to 3.2% (54/1681) among those tested with WM. Among 77 unique female patients with TV infection, 467 (34.0%) were Black and had a median age of 28 years. Nearly half of infected women presented with a chief complaint of abdominal pain (49%); vaginal discharge was only reported by 10%. Among infected women, 55% had concomitant bacterial vaginosis (BV), and 16% were co-infected with gonorrhoea and/or chlamydia. Most infected women (84%) were prescribed metronidazole during the same ER visit.
Conclusions . The OSOM® Trichomonas Rapid Test resulted in a 60% increase in TV detection among women compared to WM, and the majority received appropriate TV therapy. Women identified with TV infection in an ER setting were primarily co-infected with BV and other STIs.
- diagnostic methods
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