PT  - JOURNAL ARTICLE
AU  - B A Paterson
AU  - S N Tabrizi
AU  - S M Garland
AU  - C K Fairley
AU  - F J Bowden
TI  - The tampon test for trichomoniasis: a comparison between conventional methods and a polymerase chain reaction for Trichomonas vaginalis in women.
AID  - 10.1136/sti.74.2.136
DP  - 1998 Apr 01
TA  - Sexually Transmitted Infections
PG  - 136--139
VI  - 74
IP  - 2
4099  - http://sti.bmj.com/content/74/2/136.short
4100  - http://sti.bmj.com/content/74/2/136.full
SO  - Sex Transm Infect1998 Apr 01; 74
AB  - OBJECTIVES: Trichomonas vaginalis is the most common STD worldwide and the infection has been linked with an increased risk of HIV transmission. We present a detailed comparison between conventional collection and testing methods and the polymerase chain reaction (PCR) tampon test for T vaginalis. METHODS: Women were tested for the presence of T vaginalis by PCR analysis of a tampon specimen and by conventional methods which included one or more of the following: culture and microscopy from a high vaginal swab (HVS) or endocervical swab (ECS), and microscopy of a Papanicolaou (Pap) smear. RESULTS: T vaginalis was detected in 51/590 (8.6%) conventional tests and 93/590 (15.8%) tampon specimens. Retesting of all tampon PCR positive specimens confirmed 89/93 (95.7%) tests. Using the tampon PCR as the reference, the sensitivities of the different conventional sampling and testing methods for the detection of T vaginalis were 8.3% (5/60) for ECS microscopy or culture, 31% (13/42) for HVS microscopy or culture, 52.8% (19/36) for HVS directly inoculated into Trichomonas medium and 59.4% (38/64) for Pap smear. CONCLUSIONS: No conventional test in the remote setting has comparable sensitivity to PCR. The Pap smear is the next most sensitive, but requires a speculum examination. The use of PCR will allow inclusion of T vaginalis into STD screening programmes in both developed (lower prevalence) and developing (higher prevalence) countries.