title: Trichomonas vaginalis polymerase chain reaction compared with standard diagnostic and therapeutic protocols for detection and treatment of vaginal trichomoniasis.
abstract: Wet preparation has limited sensitivity for diagnosis of Trichomonas vaginalis (TV) infection. An observational study of 337 women was conducted to evaluate a new polymerase chain reaction (PCR) test for TV. The sensitivities of wet preparation and TV culture were 52% (95% confidence interval [CI], 41-62) and 78% (95% CI, 69-86), respectively. TV PCR had a sensitivity of 84% (95% CI, 75-90) and a specificity of 94% (95% CI, 90-97). Metronidazole was provided to 67 (69%) of 97 women with TV because of TV on wet preparation, exposure to TV, or a diagnosis of bacterial vaginosis or pelvic inflammatory disease; however, if TV PCR had been used for diagnosis, 81 (84%) of 97 women with TV would have been treated (P=.02). TV is significantly undertreated using standard algorithms for metronidazole therapy. Given the association of trichomoniasis with perinatal morbidity and HIV transmission, women in high-risk groups may benefit from TV PCR.
authors.affiliation: Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA. karen-wendel@ouhsc.edu
authors.forename: Karen A
authors.initials: KA
authors.lastname: Wendel
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Erbelding
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
authors.forename: Anne M
authors.initials: AM
authors.lastname: Rompalo
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000994:Antitrichomonal Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012749:Sexually Transmitted Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology; D014247:Trichomonas Vaginitis / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission; D014246:Trichomonas vaginalis / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000994:Antitrichomonal Agents; D008795:Metronidazole