Self-collected Vaginal Swabs for the Detection of Multiple Sexually Transmitted Infections in Adolescent Girls

Holland-Hall, Cynthia; Wiesenfeld, Harold C.; Murray, Pamela J.

doi:10.1016/s1083-3188(02)00197-3

Cited by 59 publications

(91 citation statements)

References 31 publications

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“…Our prevalence rate for T. vaginalis is lower than many reports of testing in high-risk populations (7,11). It is more similar to the 5% prevalence determined for enlisted Army women attending a military epidemiology clinic (STD clinic) using the same trichomonal culture technique as that used in the present study (20).…”

Section: Discussionsupporting

confidence: 69%

Comparing First-Void Urine Specimens, Self-Collected Vaginal Swabs, and Endocervical Specimens To DetectChlamydia trachomatisandNeisseria gonorrhoeaeby a Nucleic Acid Amplification Test

et al. 2003

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We set out to determine the prevalences of Chlamydia trachomatis and Neisseria gonorrhoeae by ligase chain reaction as well as to determine the prevalence of Trichomonas vaginalis by culture in a large and diverse national sample of non-health-care-seeking young women entering the military; we also sought to compare the abilities of three different techniques of collecting specimens (first-void urine, self-collected vaginal swab, and clinician-collected endocervical swab) to identify a positive specimen. A cross-sectional sample of young women was voluntarily recruited; as a part of their routine entry pelvic examination visit, they completed a selfadministered reproductive health questionnaire and provided first-void urine (used to detect C. trachomatis and N. gonorrhoeae) and self-collected vaginal swabs (used to detect C. trachomatis, N. gonorrhoeae, and T. vaginalis). The number of positive tests divided by the number of sexually active women screened by each sampling method determined the rates of prevalence. The rate of infection with any of the three sexually transmitted diseases (STDs) tested was 14.1%. The total positive rates for each STD (identified by >1 specimen) were the following: for C. trachomatis, 11.6%; N. gonorrhoeae, 2.4%; and T. vaginalis, 1.7%. The proportions of positives identified by specimen type were, for C. trachomatis and N. gonorrhoeae, respectively, endocervix, 65 and 40%; urine, 72 and 24%; and vagina, 81 and 72%. The proportions of positives when specimen results were combined were, for C. trachomatis and N. gonorrhoeae, respectively, cervix plus urine, 86 and 49%; cervix plus vagina, 91 and 93%; and vagina plus urine, 94 and 79%. We concluded that STDs were epidemic in this population. Self-collected vaginal swabs identified the highest number of positive test results among single specimens, with the combined cervix-vagina results identifying the highest number of positive results. Self-collected vaginal swab collections are a feasible alternative to cervical specimen collections in this population, and the use of multiple types of specimens increases the positive yield markedly.Chlamydia trachomatis remains epidemic among sexually active young women (5). Health policy organization guidelines recommend annual chlamydial screening of sexually active adolescent and young adult females (1, 2, 29). Nucleic acid amplification technique (NAAT) applied to endocervical samples has proven to be a sensitive nonculture method to screen young women for C. trachomatis, with sensitivities ranging from 75 to 100% and with many reporting sensitivities greater than 90% (6,7,21,22,27,30,31). A further advance has been the application of the NAAT to first-void urine (FVU) samples to detect C. trachomatis with reported sensitivities of 50 to 95% (6,7,15,22,25,27,30,31). This noninvasive form of specimen collection has been shown to be a cost-effective tool for chlamydial screening when compared to endocervical swabs because such collections do not require invasive pelvic examinations (24). Finally...

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Section: Discussionsupporting

confidence: 69%

Comparing First-Void Urine Specimens, Self-Collected Vaginal Swabs, and Endocervical Specimens To DetectChlamydia trachomatisandNeisseria gonorrhoeaeby a Nucleic Acid Amplification Test

et al. 2003

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“…Holland-Hall et al [15] studied adolescents in a correctional institution of Pennsylvania, in the United States of America, to evaluate the use and acceptance of self-collected vaginal swab in the molecular biology test for gonococcus, chlamydia, and trichomonas. They found exams positive for trichomonas in 11.7%, for chlamydia in 11.3% and for gonococcus in 8.5%.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of a self-collection kit for the microbiological study of the vaginal content

et al. 2007

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Diagnosis of vaginal discharge is frequently performed in an empirical way, leading to inadequate treatment. This study tested the accuracy of a self-collection kit for microbiological study of the vaginal content. One hundred and forty-two women of Family Health Program units in Niterói and Piraí cities were enrolled in order to have their vaginal content studied. A brief explanation and a self-collection kit were provided in order to sample the vaginal content. The self-collection kit was composed of one empty plastic tube, two glass slides, a long handle cytobrush, an identification card and guideline notes. The vaginal sample was applied on the glass slides by the women and stained by Gram technique. A second sampling was done by the medical personnel. The microbiological diagnosis in a blinded analysis was made under optical microscopy. A validation diagnosis test was done taking the medical collection results as a gold standard. A total of 106 women had followed the protocol and were included in the study. Microbiological analysis was unsatisfactory in 12 cases (6 cases of self-collection material and 6 cases of medical collection). The microbiological analyses in the self-collection and in the medical collection material were respectively: bacterial vaginosis in 21.7% and 17.9%, non bacillar flora in 10.3% and 11.3%, vaginal trichomoniasis in 5.66% and 5.6%, candidiasis in 3.78% and 2.8% and a normal microbiota in 52.8% and 56.6%. The Kappa coefficient suggested a "very good correlation" of the microbiological results between the two methods of collection (K=0.7945). The selfcollection kit provides samples for microbiological analysis of the vaginal microbiota as good as medical collection.

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“…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.…”

Section: Introductionmentioning

confidence: 99%

Acceptability of Self-Testing for Trichomoniasis Increases with Experience

Huppert

Bernard

Hesse

et al. 2010

Journal of Adolescent Health

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Self-collected Vaginal Swabs for the Detection of Multiple Sexually Transmitted Infections in Adolescent Girls

Cited by 59 publications

References 31 publications

Comparing First-Void Urine Specimens, Self-Collected Vaginal Swabs, and Endocervical Specimens To DetectChlamydia trachomatisandNeisseria gonorrhoeaeby a Nucleic Acid Amplification Test

Comparing First-Void Urine Specimens, Self-Collected Vaginal Swabs, and Endocervical Specimens To DetectChlamydia trachomatisandNeisseria gonorrhoeaeby a Nucleic Acid Amplification Test

Accuracy of a self-collection kit for the microbiological study of the vaginal content

Acceptability of Self-Testing for Trichomoniasis Increases with Experience

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