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Epidemiology
Original Article
Rapid and point-of-care tests for the diagnosis of Trichomonas vaginalis in women and men
  1. Charlotte A Gaydos1,
  2. Jeffrey D Klausner2,
  3. Nitika Pant Pai3,
  4. Helen Kelly4,
  5. Cordelia Coltart4,
  6. Rosanna W Peeling4
  1. 1Division of Infectious Diseases, Medicine Baltimore, Johns Hopkins University, Baltimore, Maryland, USA
  2. 2Division of Infectious Diseases, Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
  3. 3Department of Epidemiology, McGill University, Montreal, Canada
  4. 4London School of Hygiene & Tropical Medicine, London, UK
  1. Correspondence to Dr. Charlotte A Gaydos, Division of Infectious Diseases Johns Hopkins University 855 North Wolfe St., 530 Rangos Building Baltimore, MD 21205, USA; cgaydos{at}jhmi.edu

Abstract

Background Trichomonasvaginalis (TV) is a highly prevalent parasitic infection worldwide. It is associated with many adverse reproductive health outcomes. Many infections are asymptomatic and syndromic management leads to underdetection of TV. Traditional methods of TV detection such as wet preparation are insensitive. New rapid, point-of-care (POC) tests can enhance the diagnosis of trichomoniasis.

Methods The authors reviewed the literature and discuss older POC tests for TV detection, as well as the OSOM lateral flow test, the AmpliVue test, the Solana test and the GeneXpert test as well as the limitations of wet preparation and culture for detection of TV.

Results The OSOM test is easy to perform, compared with other POC tests, and is Clinical Laboratory Improvement Amendments (CLIA)-waived, equipment-free, has sensitivities of 83%–86% compared with nucleic acid amplification tests (NAATs) and can be performed in 15 min. The AmpliVue and the Solana tests are not CLIA waived and require small pieces of equipment. They are molecular amplified assays and can be completed in <1 hour. AmpliVue demonstrated a sensitivity for vaginal swabs of 100% compared with wet preparation/culture and 90.7% compared with NAATs. Solana demonstrated a sensitivity of 98.6%–100% for vaginal swabs and 92.9%–98% for female urines, compared with wet preparation/culture. Compared with other NAATs, the sensitivity for Solana was 89.7% for swabs and 100% for urine. The GeneXpert TV test for women and men is a moderately complex test, requires a small platform and can be performed in <1 hour. The sensitivity compared with wet preparation/culture for self-collected vaginal swabs was 96.4%, 98.9% for endocervical specimens and 98.4% for female urine. For men, sensitivity for urines was excellent (97.2%). The specificity for all assays was excellent.

Conclusions Several rapid POC tests have the potential to rapidly diagnose trichomoniasis in women and one is available for detection of TV in men.

  • Trichomonas
  • DNA amplification
  • Diagnosis
  • Genital tract infect
  • Testing

https://doi.org/10.1136/sextrans-2016-053063

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    Footnotes

    • Contributors CAG wrote the review, and all authors contributed. CAG, HK and CC did the search and data extraction; NPP, CAG and RWP did the data analysis; RWP and JDK designed the systematic reviews.

    • Competing interests None declared.

    • Patient consent No Human subjects involved.

    • Provenance and peer review Commissioned; externally peer reviewed.

    • Data sharing statement No data sharing statement since this is a review of POC tests for Trichomonas and contains no data for sharing that has not already been published else ware.