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Trichomonas vaginalis infection and the diagnostic significance of detection tests among Ghanaian outpatients.
BMC Womens Health. 2018 12 27; 18(1):206.BW

Abstract

BACKGROUND

There is little data on Trichomonas vaginalis infection in Ghana. This study evaluated the prevalence of trichomoniasis using different diagnostic methods and determined the risk factors for infection in patients.

METHODS

A structured questionnaire was administered. Vaginal swabs, urethral swabs and urine specimens were obtained from consenting patients; and the samples processed following standard protocols. The presence of T. vaginalis was determined using wet mount microscopy and polymerase chain reaction (PCR) as gold standard. We also assessed the diagnostic performance the JD's Trichomonas V® rapid antigen test to inform clinical practice.

RESULTS

The PCR assay detected T. vaginalis positivity in 64 of 150 patients (42.6, 95%CI:35.0, 50.6) including all positive samples of wet mount microscopy and JD's Trichomonas V® test. Wet mount microscopy showed low sensitivity (31.6%), high specificity (100%), moderate positive predictive value (75.0%), moderate positive likelihood ratio (3.0), and weak agreement (Cohen's kappa, 0.283) with PCR assay. The JD's Trichomonas V® test displayed lower sensitivity (25.0%), specificity (83.3%), and weaker measure of agreement (Cohen's kappa, 0.233) with PCR. In multivariate analysis, the strongest independent predictor for T. vaginalis was female gender [adjusted odds ratio (AOR), 24.89; 95% confidence interval (CI): 10.58, 51.21; P-value< 0.001]. Knowledge of STI showed a protective effect against infection with the parasite (AOR, 0.13; 95%CI: 0.07, 0.29; P-value< 0.017).

CONCLUSION

The sensitivity of wet mount microscopy was low for T. vaginalis screening in our region. The JD's Trichomonas V® test should not be considered as an alternative test. We recommend mandatory PCR assay for confirmation of negative wet mount results.

Authors+Show Affiliations

Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-bu, Accra, Ghana. rhasmah@chs.edu.gh.Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-bu, Accra, Ghana.Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-bu, Accra, Ghana.Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-bu, Accra, Ghana.School of Life Sciences, University of Nottingham, Nottingham, UK.Camboni Catholic Hospital, Sogakope, Ghana.Camboni Catholic Hospital, Sogakope, Ghana.Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-bu, Accra, Ghana.

Pub Type(s)

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

Language

eng

PubMed ID

30591043

Citation

Asmah, Richard Harry, et al. "Trichomonas Vaginalis Infection and the Diagnostic Significance of Detection Tests Among Ghanaian Outpatients." BMC Women's Health, vol. 18, no. 1, 2018, p. 206.
Asmah RH, Agyeman RO, Obeng-Nkrumah N, et al. Trichomonas vaginalis infection and the diagnostic significance of detection tests among Ghanaian outpatients. BMC Womens Health. 2018;18(1):206.
Asmah, R. H., Agyeman, R. O., Obeng-Nkrumah, N., Blankson, H., Awuah-Mensah, G., Cham, M., Asare, L., & Ayeh-Kumi, P. F. (2018). Trichomonas vaginalis infection and the diagnostic significance of detection tests among Ghanaian outpatients. BMC Women's Health, 18(1), 206. https://doi.org/10.1186/s12905-018-0699-5
Asmah RH, et al. Trichomonas Vaginalis Infection and the Diagnostic Significance of Detection Tests Among Ghanaian Outpatients. BMC Womens Health. 2018 12 27;18(1):206. PubMed PMID: 30591043.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trichomonas vaginalis infection and the diagnostic significance of detection tests among Ghanaian outpatients. AU - Asmah,Richard Harry, AU - Agyeman,Rita Ofosuaa, AU - Obeng-Nkrumah,Noah, AU - Blankson,Harriet, AU - Awuah-Mensah,Georgina, AU - Cham,Momodou, AU - Asare,Listowell, AU - Ayeh-Kumi,Patrick Ferdinand, Y1 - 2018/12/27/ PY - 2017/02/27/received PY - 2018/12/10/accepted PY - 2018/12/29/entrez PY - 2018/12/29/pubmed PY - 2019/4/18/medline KW - Ghana KW - Polymerase chain reaction KW - Risk factors KW - Trichomoniasis KW - Wet mount SP - 206 EP - 206 JF - BMC women's health JO - BMC Womens Health VL - 18 IS - 1 N2 - BACKGROUND: There is little data on Trichomonas vaginalis infection in Ghana. This study evaluated the prevalence of trichomoniasis using different diagnostic methods and determined the risk factors for infection in patients. METHODS: A structured questionnaire was administered. Vaginal swabs, urethral swabs and urine specimens were obtained from consenting patients; and the samples processed following standard protocols. The presence of T. vaginalis was determined using wet mount microscopy and polymerase chain reaction (PCR) as gold standard. We also assessed the diagnostic performance the JD's Trichomonas V® rapid antigen test to inform clinical practice. RESULTS: The PCR assay detected T. vaginalis positivity in 64 of 150 patients (42.6, 95%CI:35.0, 50.6) including all positive samples of wet mount microscopy and JD's Trichomonas V® test. Wet mount microscopy showed low sensitivity (31.6%), high specificity (100%), moderate positive predictive value (75.0%), moderate positive likelihood ratio (3.0), and weak agreement (Cohen's kappa, 0.283) with PCR assay. The JD's Trichomonas V® test displayed lower sensitivity (25.0%), specificity (83.3%), and weaker measure of agreement (Cohen's kappa, 0.233) with PCR. In multivariate analysis, the strongest independent predictor for T. vaginalis was female gender [adjusted odds ratio (AOR), 24.89; 95% confidence interval (CI): 10.58, 51.21; P-value< 0.001]. Knowledge of STI showed a protective effect against infection with the parasite (AOR, 0.13; 95%CI: 0.07, 0.29; P-value< 0.017). CONCLUSION: The sensitivity of wet mount microscopy was low for T. vaginalis screening in our region. The JD's Trichomonas V® test should not be considered as an alternative test. We recommend mandatory PCR assay for confirmation of negative wet mount results. SN - 1472-6874 UR - https://www.unboundmedicine.com/medline/citation/30591043/Trichomonas_vaginalis_infection_and_the_diagnostic_significance_of_detection_tests_among_Ghanaian_outpatients_ DB - PRIME DP - Unbound Medicine ER -