Evaluation of Self-Collected Vaginal Swab, First Void Urine, and Endocervical Swab Specimens for the Detection of Chlamydia Trachomatis and Neisseria Gonorrhoeae in Adolescent Females

Abstract

OBJECTIVE-To assess the concordance of self-obtained vaginal swabs (SVS), first void urine samples (FVU) and provider-collected endocervical swabs (PES) for the detection of chlamydia trachomatis (CT) and neisseria gonorrrhoeae (NG) in adolescents.METHODS-A total of 342 adolescent women and 1,080 baseline and semi-annual visits were analyzed. FVU, SVS and PES were collected at each biannual visit. All specimens were tested by BDProbeTec ET ™ Amplified DNA Assay. Sensitivity, specificity, positive predictive value (PPV) negative predictive value (NPV) and Kappa Coefficient were calculated to evaluate the ability to identify possible infected cases using samples from three anatomic sites and the test agreement between any two of these three specimen types. Positive result from at least two of the three specimens collected from same subject at the same study visit was considered true positive. RESULTS-The positivity rates for CT and NG were 26.6 and 11.7 per 100 women respectively. The sensitivities of SVS, FVU and PES for detecting CT were 97.3%, 89.2% and 90.1% respectively. For the detection of NG, the sensitivities of the three sampling methods were 100%, 88.6% and 95.5% respectively. The specificities were between 94.7% and 99.7% for both CT and NG. Kappa coefficients of CT test results were 0.89, 0.88 and 0.83 for specimen pairs SVS*PES, SVS*FVU and PES*FVU respectively. For the detection of NG, kappa coefficients were 0.91, 0.87 and 0.91 for those three pairs (all P<0.0001). Kappa > 0.75 is considered excellent agreement between specimens.CONCLUSION-There were strong agreements among SVS, PES and FVU specimens on the detection of CT and NG infections in adolescent females using nucleic acid amplification test. SVS represented as high as or more sensitive an approach for detecting both CT and NG compared to PES. Although FVU was the least sensitive sampling method, it is also the least invasive method. Thus SVS and FVU may provide a reliable alternative to endocervical specimens for CT and NG screening.

Equal Performance of Self-Collected and Health Care Worker-Collected Pharyngeal Swabs for Group A Streptococcus Testing by PCR

“…Thoughtfully developed programs that allow appropriately selected patients or parents and other caregivers to collect throat swabs without requiring a health care visit can limit patient exposure to other sick individuals, improve health care access, increase convenience, and decrease reliance on more costly health care options such as evening urgent care clinics or emergency departments, while still restricting antibiotic use to patients with a positive GAS test result. Our findings are in keeping with those of other studies that have demonstrated success with self-swab collection options, such as influenza testing from midnasal turbinate specimens (17), sexually transmitted infection testing from vaginal swabs (18,19), and molecular testing of samples from buccal swabs (20,21), and provide the foundation for implementation of GAS self-swab programs.…”

Acceptability of Self-Testing for Trichomoniasis Increases with Experience

“…Others have examined strategies such as selfcollection (non-invasive samples) [1][2][3][4][5][6][7][8] and point-of-care (POC) tests to improve the diagnosis of STIs. [9][10][11][12] Self-collection may be advantageous for women who dislike pelvic examinations or in settings where providers cannot perform pelvic examinations.…”

“…It is unknown whether adolescents prefer self or clinician testing for trichomoniasis, which factors predict acceptability of self-testing, and whether acceptability of self-testing improves after performing the test. Thus we designed a study with the following aims: (1) to validate a scale to measure acceptability of self and clinician testing for trichomoniasis; (2) to compare the preferences for and acceptability of self versus clinician testing for STIs using a simple POC test for trichomoniasis; (3) to examine how acceptability changes after experience with testing and review of test results; and (4) to examine whether acceptability is associated with sociodemographic, behavioural or gynaecological factors.…”

Prevalencia de Chlamydia trachomatis y Neisseria gonorrhoeae en adolescentes de colegios de la zona Sabana Centro de Cundinamarca, Colombia

“…Las especificidades oscilaron entre 94,7 y 99,7 % para ambos microorganismos. Se calculó el coeficiente kappa para evaluar la concordancia entre dos combinaciones diferentes de los tres tipos de espécimen, considerándola excelente si dicho coeficiente era mayor de 0,75, y se registraron valores superiores a este (p<0,0001) en todos los casos (18).…”