Diagnosis of Trichomonas vaginalis in adolescent females: InPouch TV® culture versus wet-mount microscopy

doi:10.1016/S1054-139X(97)00214-0

Journal of Adolescent Health

Volume 22, Issue 3, March 1998, Pages 205-208

https://doi.org/10.1016/S1054-139X(97)00214-0 Get rights and content

Purpose:

This study compared the InPouch TV® culture to wet-mount, Diamond's culture medium, and Papanicolaou (Pap) smear for the diagnosis of trichomonas infection in sexually active adolescents.

Methods:

A total of 467 subjects were recruited among 12–18-year-old girls who received pelvic examinations at two urban adolescent clinics. All girls were tested by wet-mount and InPouch TV®. In addition 339 of 467 had cultures in Diamond's medium and 366 of 467 had Pap smears. Specimens were collected for InPouch TV® and Diamond's cultures and read at 24–48 h and 5 days, and in the case of Diamond's cultures, also at 7 days. In a subset of subjects (268 of 467) who had all four tests done, sensitivities and specificities were calculated using Diamond's culture as the “gold standard.”

Results:

In the 467 subjects, 73 (15.6%) tested positive for trichomonas by at least one method. In the subset with all four tests done, sensitivities of the wet-mount and InPouch TV® were 36% and 81%, respectively; while that of the Pap smear was 56%. The culture media were equally efficient in identifying Trichomonas vaginalis. There were no differences found between subjects with or without trichomonas infections in gynecological symptoms, previous history of sexually transmitted diseases, or use of a condom at last intercourse.

Conclusions:

InPouch TV® culture is a good diagnostic method for T. vaginalis because of its long shelf-life, relatively low expense, and high sensitivity (over twice as sensitive as wet-mount).

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There are more references available in the full text version of this article.

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Second, trichomonas can be detected by three methods: culture methods, wet-mount methods and PCR. And the sensitivity varies with methods (Ohlemeyer et al., 1998; Riley et al., 1995). Other factors could also cause the differences, such as climate difference, management level and sample size.
Trichomonas gallinae is a globally distributed protozoan parasite, mainly affect the upper avian digestive tract and can bring huge economic losses to pigeon industry. The objective of the present study was to determine the prevalence and genotypes of T. gallinae in Beijing, China. A total of 569 samples of throat swabs of pigeon were collected from pigeon farms in Shunyi District, Fangshan District, Daxing District and Miyun District of Beijing. The overall prevalence was 28.30%. The significant difference in infection rates was not observed between regions, but was found between age groups. The highest prevalence was nestling pigeons (33.16%), followed by adolescent pigeons (30.05%) and breeding pigeons (20.59%). Moreover, genotype A and B of T. gallinae were identified by sequencing the ITS1/5.8S/ITS2 regions and phylogenetic analysis. To our knowledge, this is the first report to display the prevalence and genotype of T. gallinae from Beijing, China.
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In contrast, culture in Diamond broth medium preserves parasite viability and requires a smaller inoculum, such that the test has a superior sensitivity as compared with wet-mount microscopy. Disadvantages of culture with Diamond broth are its cost, susceptibility to bacterial contamination, and incubation time of 2 to 7 days.38 The InPouch system (Biomed Diagnostics, White City, OR) allows testing of a vaginal discharge specimen with both wet mount and culture.
Testing for sexually transmitted infections (STIs) is an important component of the medical evaluation for sexually abused children. Selective screening of this population with culture or microscopy-based techniques has been the traditional approach, particularly in younger children who have a lower prevalence of STIs compared with adolescents. However, newer testing methodologies (nucleic acid amplification tests) that use noninvasively collected specimens enable more widespread screening in children. This article provides an updated review of recommended STI testing and interpretation in children who present with suspected sexual abuse, focusing on these emerging methodologies and the evidence to support their use.
Urethritis, Vulvovaginitis, and Cervicitis
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The importance of diagnosing trichomoniasis is highlighted by its strong association with HIV acquisition and viral shedding. The low sensitivity of wet preparation and often asymptomatic nature of trichomoniasis results in failure to recognize and treat this sexually transmitted infection. The purpose of this study was to evaluate the feasibility of screening high-risk adolescent females using a new highly sensitive and specific NAAT assay.
We enrolled a consecutive, clinical sample of 144 sexually active females, aged 13 through 21. Subjects completed a questionnaire on sexual history and current vaginal symptoms, and provided two self- or physician-collected vaginal swabs and urine. A wet preparation test was performed with one swab and the APTIMA Trichomonas vaginalis (ATV) assay (Gen-Probe, Inc.) was performed with the other and with urine.
Mean age was 18 ± 1.6 years; 55% Hispanic and 35% black. A three-fold higher prevalence of trichomoniasis (6.3%) was detected by ATV than by wet preparation (2.1%) with 100% concordance between vaginal swab and urine. Prevalence of chlamydia by APTIMA was 11%; no gonorrhea was detected. Subjects with trichomoniasis were more likely than those without to be black (P < 0.01), and to report past gonorrhea (P < 0.01) and past PID (P < 0.001). No vaginal symptom distinguished those with trichomoniasis.
Three times as many cases of trichomoniasis were identified with ATV compared to wet preparation and identical results were obtained with vaginal swabs and urine. No symptoms were associated with trichomoniasis. These findings highlight the imperative and feasibility of screening and treating at-risk populations.

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Journal of Adolescent Health

Purpose:

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Conclusions:

References (13)

Prevention of premature birth by screening and treatment for common genital tract infections: Results of a prospective controlled evaluation

Am J Obstet Gynecol

Sexual intercourse during pregnancy and preterm delivery: Effects of vaginal microorganisms

Am J Obstet Gynecol

Trichomoniasis: Trends in diagnosis and management

Am J Obstet Gynecol

Sex and America's Teenagers

Chlamydia trachomatis: Important relationships to race, contraception, lower genital tract infection, and Papanicolaou smears

J Pediatr

Prevalence of six sexually transmitted disease agents among pregnant inner-city adolescents and pregnancy outcome

Lancet

Cited by (55)

Trichomoniasis

Prevalence and molecular characterization of Trichomonas gallinae from domestic pigeons in Beijing, China

Infectious Diseases Associated With Child Abuse

Evaluating Sexually Transmitted Infections in Sexually Abused Children: New Techniques to Identify Old Infections

Urethritis, Vulvovaginitis, and Cervicitis

Screening for Trichomonas vaginalis in High-risk Adolescent Females with a New Transcription-mediated Nucleic Acid Amplification Test (NAAT): Associations with Ethnicity, Symptoms, and Prior and Current STIs

Original articleDiagnosis of Trichomonas vaginalis in adolescent females: InPouch TV® culture versus wet-mount microscopy

Purpose:

Methods:

Results:

Conclusions:

Am J Obstet Gynecol

Am J Obstet Gynecol

Am J Obstet Gynecol

Sex and America's Teenagers

Chlamydia trachomatis: Important relationships to race, contraception, lower genital tract infection, and Papanicolaou smears

J Pediatr

Prevalence of six sexually transmitted disease agents among pregnant inner-city adolescents and pregnancy outcome

Lancet

Original article
Diagnosis of Trichomonas vaginalis in adolescent females: InPouch TV® culture versus wet-mount microscopy