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Aptima Trichomonas vaginalis assay elucidates significant underdiagnosis of trichomoniasis among women in Brazil according to an observational study.
Sex Transm Infect. 2019 03; 95(2):129-132.ST

Abstract

OBJECTIVES

Trichomonas vaginalis (TV) infection is the most common non-viral STI globally and can result in adverse pregnancy outcomes and exacerbated HIV acquisition/transmission. Nucleic acid amplification tests (NAATs) are the most sensitive diagnostic tests, with high specificity, but TV NAATs are rarely used in Brazil. We investigated the TV prevalence and compared the performance of the US Food and Drug Association-cleared Aptima TV assay with microscopy (wet mount and Gram-stained) and culture for TV detection in women in Pelotas, Brazil in an observational study.

METHODS

From August 2015 to December 2016, 499 consecutive asymptomatic and symptomatic sexually active women attending a Gynaecology and Obstetrics Outpatient Clinic were enrolled. Vaginal fluid and swab specimens were collected and wet mount microscopy, Gram-stained microscopy, culture and the Aptima TV assay performed.

RESULTS

The median age of enrolled women was 36.5 years (range: 15-77). The majority were white, had a steady sexual partner and low levels of education. The TV detection rate was 4.2%, 2.4%, 1.2% and 0% using the Aptima TV assay, culture, wet mount microscopy and Gram-stained microscopy, respectively. The sensitivity of culture and wet mount microscopy was only 57.1% (95% CI 36.5 to 75.5) and 28.6% (95% CI 13.8 to 50.0), respectively.

CONCLUSIONS

A 4.2% positivity rate of T. vaginalis was found among women in Pelotas, Brazil and the routine diagnostic test (wet mount microscopy) and culture had low sensitivities. More sensitive diagnostic tests (NAATs) and enhanced testing of symptomatic and asymptomatic at-risk women are crucial to mitigate the transmission of TV infection, TV-associated sequelae and enhanced HIV acquisition and transmission.

Authors+Show Affiliations

Post Graduation Program in Parasitology, Biology Institute, Federal University of Pelotas (UFPel), Pelotas, Brazil.Maternal and Child Department, School of Medicine, Federal University of Pelotas (UFPel), Pelotas, Brazil.Maternal and Child Department, School of Medicine, Federal University of Pelotas (UFPel), Pelotas, Brazil.Maternal and Child Department, School of Medicine, Federal University of Pelotas (UFPel), Pelotas, Brazil.Post Graduation Program in Parasitology, Biology Institute, Federal University of Pelotas (UFPel), Pelotas, Brazil.Post Graduation Program in Parasitology, Biology Institute, Federal University of Pelotas (UFPel), Pelotas, Brazil.WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.WHO Collaborating Centre for Gonorrhoea and other STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden magnus.unemo@orebroll.se.

Pub Type(s)

Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30154157

Citation

Bruni, Mirian Pinheiro, et al. "Aptima Trichomonas Vaginalis Assay Elucidates Significant Underdiagnosis of Trichomoniasis Among Women in Brazil According to an Observational Study." Sexually Transmitted Infections, vol. 95, no. 2, 2019, pp. 129-132.
Bruni MP, Freitas da Silveira M, Stauffert D, et al. Aptima Trichomonas vaginalis assay elucidates significant underdiagnosis of trichomoniasis among women in Brazil according to an observational study. Sex Transm Infect. 2019;95(2):129-132.
Bruni, M. P., Freitas da Silveira, M., Stauffert, D., Bicca, G. L. O., Caetano Dos Santos, C., da Rosa Farias, N. A., Golparian, D., & Unemo, M. (2019). Aptima Trichomonas vaginalis assay elucidates significant underdiagnosis of trichomoniasis among women in Brazil according to an observational study. Sexually Transmitted Infections, 95(2), 129-132. https://doi.org/10.1136/sextrans-2018-053635
Bruni MP, et al. Aptima Trichomonas Vaginalis Assay Elucidates Significant Underdiagnosis of Trichomoniasis Among Women in Brazil According to an Observational Study. Sex Transm Infect. 2019;95(2):129-132. PubMed PMID: 30154157.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aptima Trichomonas vaginalis assay elucidates significant underdiagnosis of trichomoniasis among women in Brazil according to an observational study. AU - Bruni,Mirian Pinheiro, AU - Freitas da Silveira,Mariangela, AU - Stauffert,Dulce, AU - Bicca,Guilherme Lucas de Oliveira, AU - Caetano Dos Santos,Carolina, AU - da Rosa Farias,Nara Amélia, AU - Golparian,Daniel, AU - Unemo,Magnus, Y1 - 2018/08/28/ PY - 2018/03/31/received PY - 2018/07/17/revised PY - 2018/08/07/accepted PY - 2018/8/30/pubmed PY - 2019/5/1/medline PY - 2018/8/30/entrez KW - Brazil KW - aptima KW - culture KW - nucleic acid amplification test (NAAT) KW - trichomonas infection KW - trichomonas vaginalis KW - trichomoniasis KW - wet mount microscopy SP - 129 EP - 132 JF - Sexually transmitted infections JO - Sex Transm Infect VL - 95 IS - 2 N2 - OBJECTIVES: Trichomonas vaginalis (TV) infection is the most common non-viral STI globally and can result in adverse pregnancy outcomes and exacerbated HIV acquisition/transmission. Nucleic acid amplification tests (NAATs) are the most sensitive diagnostic tests, with high specificity, but TV NAATs are rarely used in Brazil. We investigated the TV prevalence and compared the performance of the US Food and Drug Association-cleared Aptima TV assay with microscopy (wet mount and Gram-stained) and culture for TV detection in women in Pelotas, Brazil in an observational study. METHODS: From August 2015 to December 2016, 499 consecutive asymptomatic and symptomatic sexually active women attending a Gynaecology and Obstetrics Outpatient Clinic were enrolled. Vaginal fluid and swab specimens were collected and wet mount microscopy, Gram-stained microscopy, culture and the Aptima TV assay performed. RESULTS: The median age of enrolled women was 36.5 years (range: 15-77). The majority were white, had a steady sexual partner and low levels of education. The TV detection rate was 4.2%, 2.4%, 1.2% and 0% using the Aptima TV assay, culture, wet mount microscopy and Gram-stained microscopy, respectively. The sensitivity of culture and wet mount microscopy was only 57.1% (95% CI 36.5 to 75.5) and 28.6% (95% CI 13.8 to 50.0), respectively. CONCLUSIONS: A 4.2% positivity rate of T. vaginalis was found among women in Pelotas, Brazil and the routine diagnostic test (wet mount microscopy) and culture had low sensitivities. More sensitive diagnostic tests (NAATs) and enhanced testing of symptomatic and asymptomatic at-risk women are crucial to mitigate the transmission of TV infection, TV-associated sequelae and enhanced HIV acquisition and transmission. SN - 1472-3263 UR - https://www.unboundmedicine.com/medline/citation/30154157/Aptima_Trichomonas_vaginalis_assay_elucidates_significant_underdiagnosis_of_trichomoniasis_among_women_in_Brazil_according_to_an_observational_study_ DB - PRIME DP - Unbound Medicine ER -