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A comparative evaluation of the Papanicolaou test for the diagnosis of trichomoniasis.
Sex Transm Dis. 2003 Sep; 30(9):694-9.ST

Abstract

BACKGROUND

Trichomoniasis is the most prevalent nonviral sexually transmitted disease in humans worldwide. In addition to its pathologic implications, trichomoniasis is a risk factor for the transmission of the HIV and is associated with reproductive complications in females. Diagnosis of the disease is problematic due to inadequate accuracy of current diagnostic methods. Recently developed DNA-based techniques for detection of Trichomonas vaginalis seem to be promising alternatives.

GOAL

The goal of this study was to evaluate the accuracy of the Papanicolaou test for the diagnosis of trichomoniasis by comparing polymerase chain reaction (PCR) with other current diagnostic methods.

STUDY DESIGN

A total of 1008 cervicovaginal swab specimens from a randomized population attending a gynecological service were analyzed in this study. In addition to current diagnostic methods, two sets of specific primers were used for PCR detection of T vaginalis in the cervicovaginal DNA samples, with a PCR quality control. Different examiners conducted PCR and Papanicolaou analyses in a double-blind trial.

RESULTS

The prevalence of trichomoniasis in this population was 6%. A considerable number of diagnostic results of the Papanicolaou test were false negative or false positive. Compared with PCR, specificity of the Papanicolaou test was 97.6%, whereas sensitivity was only 60.7%. The positive predictive value of the Papanicolaou smear was 61.7%. These results suggest that irregularly shaped parasites without clearly defined nuclei and flagella and bacteria-induced focal cytolysis limit the ability of the Papanicolaou test to detect T vaginalis.

CONCLUSION

The Papanicolaou test, the most readily available cytologic method for screening sexually transmitted pathogens and cellular abnormalities in most developing countries, is inadequate for the diagnosis of trichomoniasis due to its inherent limitations. However, PCR is a highly sensitive and specific test for the diagnosis of trichomoniasis.

Authors+Show Affiliations

Lobo TT
Program of Genomic Sciences and Molecular Biotechnology, Universidade Católica de Brasília, Brasília DF, Brazil.
Feijó G
No affiliation info available
Carvalho SE
No affiliation info available
Costa PL
No affiliation info available
Chagas C
No affiliation info available
Xavier J
No affiliation info available
Simoes-Barbosa A
No affiliation info available

MeSH

AdultAnimalsBrazilDNA PrimersDNA, ProtozoanDouble-Blind MethodFalse Negative ReactionsFemaleHumansPapanicolaou TestPolymerase Chain ReactionPredictive Value of TestsPrevalenceSensitivity and SpecificityTrichomonas VaginitisTrichomonas vaginalisVaginal Smears

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12972792

Citation

Lobo, Tatiana T., et al. "A Comparative Evaluation of the Papanicolaou Test for the Diagnosis of Trichomoniasis." Sexually Transmitted Diseases, vol. 30, no. 9, 2003, pp. 694-9.
Lobo TT, Feijó G, Carvalho SE, et al. A comparative evaluation of the Papanicolaou test for the diagnosis of trichomoniasis. Sex Transm Dis. 2003;30(9):694-9.
Lobo, T. T., Feijó, G., Carvalho, S. E., Costa, P. L., Chagas, C., Xavier, J., & Simoes-Barbosa, A. (2003). A comparative evaluation of the Papanicolaou test for the diagnosis of trichomoniasis. Sexually Transmitted Diseases, 30(9), 694-9.
Lobo TT, et al. A Comparative Evaluation of the Papanicolaou Test for the Diagnosis of Trichomoniasis. Sex Transm Dis. 2003;30(9):694-9. PubMed PMID: 12972792.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparative evaluation of the Papanicolaou test for the diagnosis of trichomoniasis. AU - Lobo,Tatiana T, AU - Feijó,Gilvania, AU - Carvalho,Sandra E, AU - Costa,Patrícia L, AU - Chagas,Carolina, AU - Xavier,Joaquim, AU - Simoes-Barbosa,Augusto, PY - 2003/9/16/pubmed PY - 2003/10/28/medline PY - 2003/9/16/entrez SP - 694 EP - 9 JF - Sexually transmitted diseases JO - Sex Transm Dis VL - 30 IS - 9 N2 - BACKGROUND: Trichomoniasis is the most prevalent nonviral sexually transmitted disease in humans worldwide. In addition to its pathologic implications, trichomoniasis is a risk factor for the transmission of the HIV and is associated with reproductive complications in females. Diagnosis of the disease is problematic due to inadequate accuracy of current diagnostic methods. Recently developed DNA-based techniques for detection of Trichomonas vaginalis seem to be promising alternatives. GOAL: The goal of this study was to evaluate the accuracy of the Papanicolaou test for the diagnosis of trichomoniasis by comparing polymerase chain reaction (PCR) with other current diagnostic methods. STUDY DESIGN: A total of 1008 cervicovaginal swab specimens from a randomized population attending a gynecological service were analyzed in this study. In addition to current diagnostic methods, two sets of specific primers were used for PCR detection of T vaginalis in the cervicovaginal DNA samples, with a PCR quality control. Different examiners conducted PCR and Papanicolaou analyses in a double-blind trial. RESULTS: The prevalence of trichomoniasis in this population was 6%. A considerable number of diagnostic results of the Papanicolaou test were false negative or false positive. Compared with PCR, specificity of the Papanicolaou test was 97.6%, whereas sensitivity was only 60.7%. The positive predictive value of the Papanicolaou smear was 61.7%. These results suggest that irregularly shaped parasites without clearly defined nuclei and flagella and bacteria-induced focal cytolysis limit the ability of the Papanicolaou test to detect T vaginalis. CONCLUSION: The Papanicolaou test, the most readily available cytologic method for screening sexually transmitted pathogens and cellular abnormalities in most developing countries, is inadequate for the diagnosis of trichomoniasis due to its inherent limitations. However, PCR is a highly sensitive and specific test for the diagnosis of trichomoniasis. SN - 0148-5717 UR - https://www.unboundmedicine.com/medline/citation/12972792/A_comparative_evaluation_of_the_Papanicolaou_test_for_the_diagnosis_of_trichomoniasis_ DB - PRIME DP - Unbound Medicine ER -