title: Self-collected versus health professional-collected genital swabs to identify the prevalence of group B streptococcus: a comparison of patient preference and efficacy.
abstract: OBJECTIVE
  This study aims to determine the prevalence of genital tract group B streptococcus (GBS) colonization in a cohort of pregnant Irish women and to compare patient preference and efficacy of self-collected versus health professional-collected swabs.
  
  
  METHODS
  In this prospective cohort study, 600 pregnant women attending public and private antenatal clinics at the Unified Maternity Services, Cork were included. At 35-37 weeks of pregnancy, these women self-collected an ano-vaginal swab and a health professional-collected a second swab on same clinic visit. The women filled a questionnaire to indicate their preferences. Statistical analysis was performed on SPSS Version 13.
  
  
  RESULTS
  The cumulative prevalence of maternal GBS colonization was 11.7% (95% CI, 9.3-14.6). The sensitivity of the self-collected swab was 84.3% (95% CI, 73.2-91.5) and that of health professional-collected swab was 94.3% (95% CI, 85.3-98.2). While good agreement in efficacy was found between health professional and patient-collected swabs (Kappa=0.87, p<0.001, 97.5% measure of concordance), only 28.5% women preferred self-collection, while 43.2% preferred a health professional to collect the swab and 28.3% had no preference.
  
  
  CONCLUSIONS
  In our study the concordance between health professional and self-collected swab was excellent. However, pregnant women mainly prefer a health professional to collect their ano-vaginal swabs.
authors.affiliation: Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Cork, Ireland. a.arya@ucc.ie
authors.forename: Anna
authors.initials: A
authors.lastname: Arya
authors.forename: Bartley
authors.initials: B
authors.lastname: Cryan
authors.forename: Kathleen
authors.initials: K
authors.lastname: O'Sullivan
authors.forename: Richard A
authors.initials: RA
authors.lastname: Greene
authors.forename: John R
authors.initials: JR
authors.lastname: Higgins
mesh_terms: D000328:Adult; D002353:Carrier State / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D017060:Patient Satisfaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011296:Prenatal Diagnosis / Q000379:methods; D015995:Prevalence; D012648:Self Care / Q000379:methods; D013048:Specimen Handling / Q000379:methods*; D013290:Streptococcal Infections / Q000175:diagnosis*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*