Two methods of self-sampling compared to clinician sampling to detect reproductive tract infections in Gugulethu, South Africa.
OBJECTIVE
To assess the validity, feasibility, and acceptability of 2 methods of self-sampling compared to clinician sampling during a speculum examination.


OBJECTIVE
To improve screening for reproductive tract infections (RTIs) in resource-poor settings.


METHODS
In a public clinic in Cape Town, 450 women underwent a speculum examination and were randomized to self-sample with either a tampon or vaginal swabs. All specimens were tested for the same pathogens using the same diagnostic tests.


RESULTS
Self-sampling resulted in satisfactory validity for N gonorrhoeae, C trachomatis, bacterial vaginosis, and Candida species (tampons and swabs) and high-risk human papillomavirus (swabs only) when tested with molecular tests or microscopy, but not for T vaginalis by culture. Self-sampling was feasible and acceptable, but some women preferred speculum examinations, which allow the clinician to view the vagina and cervix.


CONCLUSIONS
Although self-sampling should not replace speculum examinations in all circumstances, it should be explored further as an RTI screening strategy.
Population Council, New York, New York, USA. jvandewijgert@iatec.com
Janneke
J
van de Wijgert
Lydia
L
Altini
Heidi
H
Jones
Alana
A
de Kock
Taryn
T
Young
Anna-Lise
AL
Williamson
Anwar
A
Hoosen
Nicol
N
Coetzee
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002175:Candida / Q000302:isolation & purification; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003151:Community Health Centers; D005260:Female; D006801:Humans; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D027383:Papillomaviridae / Q000302:isolation & purification; D010342:Patient Acceptance of Health Care; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000469:parasitology / Q000517:prevention & control; D013019:South Africa; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D014626:Vaginal Smears / Q000379:methods / Q000592:standards*