Systematic review of diagnostic tests for vaginal trichomoniasis.
OBJECTIVE
To review critically and to summarize the evidence of diagnostic tests and culture media for the diagnosis of Trichomonas vaginitis.


METHODS
We performed a systematic review of literature indexed in MEDLINE of studies that used Trichomonas culture as the reference standard (9,882 patients, 35 studies). Level I studies (5,047 patients, 13 studies) fulfilled at least two of three criteria: 1) consecutive patients were evaluated prospectively, 2) decision to culture was not influenced by test results, and 3) there was independent and blind comparison to culture.


RESULTS
The sensitivity of the polymerase chain reaction technique (PCR) was 95% (95% CI 91% to 99%), and the specificity was 98% (95% CI 96% to 100%). One study was classified as Level I evidence (52 patients). The sensitivity of the enzyme-linked immunosorbent assay was 82% (95% CI 74% to 90%), and the specificity was 73% (95% CI 35% to 100%). The sensitivity of the direct fluorescence antibody was 85% (95% CI 79% to 90%), and the specificity was 99% (95% CI 98% to 100%). Sensitivities of culture media were 95% for Diamond's, 96% for Hollander, and 95% for CPLM.


CONCLUSIONS
The sensitivity and specificity of tests to diagnose trichomoniasis vary widely.
Patel
S R
SR
Section of General Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA.
Wiese
W
W
Patel
S C
SC
Ohl
C
C
Byrd
J C
JC
Estrada
C A
CA
D000818:Animals; D003470:Culture Media; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D016239:MEDLINE; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014247:Trichomonas Vaginitis / Q000175:diagnosis* / Q000382:microbiology; D014246:Trichomonas vaginalis / Q000302:isolation & purification*
D003470:Culture Media