Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 4000, Cincinnati, OH 45229-3039, USA.
Sex Transm Infect. 2010 Dec;86(7):514-9. doi: 10.1136/sti.2009.042168. Epub 2010 Jun 30.
To compare the accuracy (ie, correlation, sensitivity, specificity) of self-performed point-of-care (POC) tests with clinician-performed tests for trichomoniasis in adolescent women.
Sexually experienced women aged 14-22 years (n=209) collected a vaginal swab and performed a POC test for trichomoniasis. Using a speculum, the clinician obtained vaginal swabs that were tested for trichomoniasis using the POC test, wet mount, culture and transcription-mediated amplification (TMA) using standard and alternative primers. Self and clinician results were compared with true positives, defined as either culture-positive or TMA-positive with both sets of primers.
Participants' mean age was 17.8 years; 87% were African-American; 74% reported vaginal itching or discharge and 51 (24%) had trichomoniasis. Over 99% correctly performed and interpreted her self-test. Self and clinician POC tests were highly correlated (95.7% agreement, κ 0.87). Compared with true positives, the sensitivity of the self-POC test was 78% (CI 65% to 89%), similar to that of the clinician-POC test (84%, CI 71% to 93%) and culture (82%, CI 69% to 92%), and significantly better than wet mount (39%, CI 26% to 54%). The specificity of the self-POC test was 99% (CI 96% to 100%), similar to that of the clinician-POC test (100%, CI 98% to 100%). The sensitivity of the self-POC test was not affected by vaginal symptoms or other variables.
Young women performing a self-POC test detected as many trichomoniasis infections as clinician-POC tests or culture, twice as many as wet mount and slightly fewer than an amplified test. Incorporating self-obtained or self-performed POC tests into routine practice could effectively increase the identification and treatment of trichomoniasis in this vulnerable population.
比较自我进行的即时检测（POC）与临床医生进行的 POCT 对青少年女性滴虫病的准确性（即相关性、敏感性、特异性）。
209 名有过性经验的 14-22 岁女性采集阴道拭子并进行滴虫病 POC 检测。使用窥器，临床医生采集阴道拭子，使用 POC 检测、湿片检查、培养和转录介导扩增（TMA）用标准和替代引物检测滴虫病。将自我和临床医生的结果与真阳性进行比较，真阳性定义为两组引物均培养阳性或 TMA 阳性。
参与者的平均年龄为 17.8 岁；87%为非裔美国人；74%报告阴道瘙痒或分泌物，51 人（24%）患有滴虫病。超过 99%的人正确进行并解释了她的自我检测。自我和临床医生的 POC 检测高度相关（95.7%的一致性，κ=0.87）。与真阳性相比，自我 POC 检测的敏感性为 78%（CI 65%至 89%），与临床医生 POC 检测（84%，CI 71%至 93%）和培养（82%，CI 69%至 92%）相似，明显优于湿片检查（39%，CI 26%至 54%）。自我 POC 检测的特异性为 99%（CI 96%至 100%），与临床医生 POC 检测（100%，CI 98%至 100%）相似。自我 POC 检测的敏感性不受阴道症状或其他变量的影响。
年轻女性进行自我 POC 检测可检测到与临床医生 POC 检测或培养一样多的滴虫病感染，是湿片检查的两倍，略低于扩增检测。将自我获得或自我执行的 POC 检测纳入常规实践可以有效地增加在这个弱势群体中识别和治疗滴虫病的机会。
