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Infectious Diseases in Obstetrics and Gynecology
Volume 8, Issue 5-6, Pages 248-257
http://dx.doi.org/10.1155/S1064744900000375

Systematic Review of Diagnostic Tests for Vaginal Trichomoniasis

Section of General Internal Medicine and Infectious Diseases, Brody School of Medicine, East Carolina University, 600 Moye Boulevard, Pitt County Memorial Hospital, Teaching Annex 389, Greenville 27858, NC, USA

Received 31 March 2000; Accepted 28 August 2000

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: To review critically and to summarize the evidence of diagnostic tests and culture media for the diagnosis of Trichomonas vaginitis.

Methods: We performed a systematic review of literature indexed in MEDLINE of studies that used Trichomonas culture as the reference standard (9,882 patients, 35 studies). Level I studies (5,047 patients, 13 studies) fulfilled at least two of three criteria: 1) consecutive patients were evaluated prospectively, 2) decision to culture was not influenced by test results, and 3) there was independent and blind comparison to culture.

Results: The sensitivity of the polymerase chain reaction technique (PCR) was 95% (95% CI 91% to 99%), and the specificity was 98% (95% CI 96% to 100%). One study was classified as Level I evidence (52 patients). The sensitivity of the enzyme-linked immunosorbent assay was 82% (95% CI 74% to 90%), and the specificity was 73% (95% CI 35% to 100%). The sensitivity of the direct fluorescence antibody was 85% (95% CI 79% to 90%), and the specificity was 99% (95% CI 98% to 100%). Sensitivities of culture media were 95% for Diamond's, 96% for Hollander, and 95% for CPLM.

Conclusions: The sensitivity and specificity of tests to diagnose trichomoniasis vary widely. Infect. Dis. Obstet. Gynecol. 8:248–257, 2000.