title: The tampon test for trichomoniasis: a comparison between conventional methods and a polymerase chain reaction for Trichomonas vaginalis in women.
abstract: OBJECTIVE
  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.
authors.affiliation: AIDS/STD Unit, Territory Health Services, Darwin, NT, Australia.
authors.forename: B A
authors.initials: BA
authors.lastname: Paterson
authors.forename: S N
authors.initials: SN
authors.lastname: Tabrizi
authors.forename: S M
authors.initials: SM
authors.lastname: Garland
authors.forename: C K
authors.initials: CK
authors.lastname: Fairley
authors.forename: F J
authors.initials: FJ
authors.lastname: Bowden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D005260:Female; D006801:Humans; D008875:Middle Aged; D010274:Parasitology / Q000379:methods*; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013630:Tampons, Surgical; D014247:Trichomonas Vaginitis / Q000175:diagnosis*; D014246:Trichomonas vaginalis / Q000302:isolation & purification*