P22 Are we using the best tests to diagnose TV in gum clinics in the UK?. (18th May 2015)

• Record Type: Journal Article
• Authors: Nicholls, Jane; Muir, Peter; Turner, Katy; May, Margaret; North, Paul; Macleod, John; Horner, Paddy
• Is Part Of: Sexually transmitted infections. Volume 91(2015)Supplement 1
• Page Start: A23
• Page End: A23
• Publication Date: 2015-05-18
• Subjects: Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2015-052126.66
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Background: The Aptima TV NAAT test has been approved for use for the detection of Trichomonas vaginalis ( TV ) and is more sensitive (˜100%) than wet mount microscopy (50%) or culture (75%). Asymptomatic women attending GUM clinics are often not tested for TV as the prevalence is assumed to be too low for testing to be cost effective. Aims: To determine TV positivity rate among GUM attendees with and without symptoms How many additional cases are identified with the new test Whether self-taken vaginal swabs are of equivalent sensitivity in symptomatic GUM patients. Methods: Patients were tested using the Aptima TV NAAT alongside existing testing methods. Test performance was compared using the McNemar test. Results: The positivity of TV determined by TV NAAT was 4.2% (22/519) in symptomatic and 1.8% (28/1599) in asymptomatic women. 9/20 NAAT positive patients, where all test were performed, would not have been identified on wet prep or culture. Overall TV NAAT outperformed currently used methods (p = 0.004), clinic wet prep vs NAAT (p = 0.038), culture vs NAAT (p = 0.002). Self-taken vaginal swabs were equivalent in sensitivity to clinician taken swabs; of patients who tested positive on either NAAT test, 19 tested positive on self-taken swab and 17 tested positive on clinician taken swab (p = 0.625). Conclusions: Testing all women attending GUM clinics with the APTIMA TV NAAT test will identify additional cases and is therefore likely to be cost-effective, and should be considered to replace conventional microbiological testing methods.