Background/introduction Laboratory tests for Trichomonas vaginalis using culture and microscopy in current practice have low sensitivity, however new, highly sensitive PCR-based nucleic acid amplification tests (TV NAATs) have been approved e.g. Aptima TV NAAT. It is not known how to optimally deploy these new tests in different settings.
Aim(s)/objectives To assess the cost-effectiveness of new TV NAAT tests for the diagnosis of TV infection in women attending genitourinary medicine (GUM) and primary care clinics. To inform national decision-making about who should be offered TV testing.
Methods We analysed data from TV tests in residual chlamydia/gonorrhoea samples from nearly 9,000 women. We conducted notes review in GUM clinics to understand current practice. We compared current and proposed pathways for management of TV. We calculated the cost of testing for TV in GUM and primary care.
Results Table 1 shows the breakdown of test results by symptomatic/asymptomatic and setting and indicates the current and new cost of testing. (NB. Provisional data, study closed 31/1/2015). Compared with current testing practice, TV NAAT testing detected an additional 41 cases from GUM. In primary care few samples were sent for laboratory testing; only 15 out of 126 NAAT positive cases would have been detected.
Discussion/conclusion TV NAAT tests detected many more infections than current testing. Nationally, this translates to an increase in GUM from 6,000 cases to 23,400 cases annually. Overall, the crude cost of adding TV NAAT testing to all chlamydia and gonorrhoea tests is £307 per additional infection diagnosed.
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