Vaginal swabs versus lavage for detection of Trichomonas vaginalis and bacterial vaginosis among HIV-positive women.
OBJECTIVE
Cervicovaginal lavage (CVL) is often used for research and may be easier and more accurate than vaginal swabs as a specimen collection method.


OBJECTIVE
The goal of this study was to compare (CVL) with vaginal swabs for the detection of bacterial vaginosis (BV) and Trichomonas vaginalis (TV).


METHODS
CVL and vaginal swabs were collected from 216 HIV-infected women. Clinical assessments were made using wet mount for TV and Amsel's criteria for BV through CVL and swab collection methods. Laboratory gold standards used were Nugent's criteria for BV and InPouch (Biomed Diagnostics, San Jose, CA) culture for TV collected by swab.


RESULTS
The prevalence by gold standards for BV was 49.3% and for TV was 25.2%. Sensitivities for direct microscopy versus culture for TV were 72.2 for CVL and 52.8 for vaginal swab (P <0.05). Sensitivities for Amsel's versus Nugent's criteria for BV were 36.2 for CVL and 34.0 for vaginal swab (P <0.80). Kappa scores of agreement between CVL and vaginal swabs for BV and TV were excellent for both.


CONCLUSIONS
CVL was comparable to vaginal swabs as a specimen collection method for these 2 lower genital tract infections and may be superior for the diagnosis of TV.
Kissinger
Patricia J
PJ
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana 70112, USA. kissing@tulane.edu
Dumestre
Jeanne
J
Clark
Rebecca A
RA
Wenthold
Luann
L
Mohammed
Hamish
H
Hagensee
Michael E
ME
Martin
David H
DH
D000328:Adult; D000818:Animals; D005260:Female; D015658:HIV Infections; D006801:Humans; D008145:Louisiana / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity; D014247:Trichomonas Vaginitis / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014246:Trichomonas vaginalis / Q000302:isolation & purification*; D014626:Vaginal Smears / Q000592:standards*; D016585:Vaginosis, Bacterial / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology