Impact of Trichomonas vaginalis Transcription-Mediated Amplification-Based Analyte-Specific-Reagent Testing in a Metropolitan Setting of High Sexually Transmitted Disease Prevalence

Trichomoniasis is a significant sexually transmitted disease (STD) in the spectrum of public health and primary care because of its association with agents such as human immunodeficiency virus and Neisseria gonorrhoeae. However, its true significance may be underestimated due to diagnostic modalitie...

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Bibliographic Details
Published in:Journal of Clinical Microbiology 2008-10, Vol.46 (10), p.3368-3374
Main Authors: Munson, Erik, Napierala, Maureen, Olson, Robin, Endes, Tina, Block, Timothy, Hryciuk, Jeanne E, Schell, Ronald F
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Chlamydia Infections - epidemiology
Comorbidity
Fundamental and applied biological sciences. Psychology
Gonorrhea - epidemiology
Humans
Microbiology
Molecular Diagnostic Techniques - methods
Parasitology
Prevalence
Sensitivity and Specificity
Sexually Transmitted Diseases - diagnosis
Sexually Transmitted Diseases - epidemiology
Trichomonas Infections - diagnosis
Trichomonas Infections - epidemiology
Trichomonas vaginalis - isolation & purification
Urban Population
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Summary:Trichomoniasis is a significant sexually transmitted disease (STD) in the spectrum of public health and primary care because of its association with agents such as human immunodeficiency virus and Neisseria gonorrhoeae. However, its true significance may be underestimated due to diagnostic modalities that exhibit poor sensitivity. A total of 1,086 genital specimens from two urban emergency departments, a suburban urgent-care facility, and a metropolitan outpatient physician group were subjected to transcription-mediated amplification-based Trichomonas vaginalis analyte-specific-reagent (ASR) testing (Gen-Probe, Inc.). The rate of positive molecular ASR results (14.5%) doubled that of direct saline preparation (7.0%; P < 0.0002). Analogous increases were observed at one emergency department and within the outpatient physician group (P < 0.0002). No significant increase in the rate of positive molecular ASR results was observed from the facilities that encountered a lower frequency of black/African American patients. While positive T. vaginalis findings via direct saline preparation did not have a significant association with concomitant Chlamydia trachomatis or N. gonorrhoeae infection overall, a positive T. vaginalis ASR result was a better predictor of concomitant C. trachomatis or N. gonorrhoeae infection (odds ratios of 2.34 and 4.46, respectively; P < 0.0001). The increased rate of positive T. vaginalis ASR results was observed in both point-of-care (P = 0.02 versus direct saline preparation) and laboratory (P = 0.003) testing. Highly sensitive T. vaginalis molecular ASR not only transcends issues of specimen integrity and microscopic acumen but also has an increased ability to predict the likelihood of additional STDs in defined populations.
ISSN:0095-1137
1098-660X
DOI:10.1128/JCM.00564-08