Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional study.
Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional study.
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DOI：
10.1186/s13104-017-2581-1
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发表时间：
2017-07-06
影响因子：
1.8
通讯作者：
Bwanga F
中科院分区：
文献类型：
--
作者：
Nabweyambo S;Kakaire O;Sowinski S;Okeng A;Ojiambo H;Kimeze J;Najjingo I;Bwanga F
阴道毛滴虫（TV）引起滴虫病综合征，包括女性阴道炎、男性尿道炎和两性输卵管感染。这种感染与胎膜早破、早产、低出生体重、促进艾滋病毒性传播和不孕症密切相关。预防这些并发症需要对感染者进行准确的早期检测和有效的治疗。在资源有限的情况下，湿封显微镜（WMM）往往是唯一可用的测试实验室检测的电视，但其准确性和聚合酶链反应（PCR）工具在乌干达仍然缺乏研究。这项横断面研究的目的是比较WMM和PCR对文化的诊断准确性，作为直接诊断有症状的妇女中TV的参考标准。在乌干达坎帕拉的Mulago国家转诊医院的性传播疾病诊所，从150名表现出活动性阴道滴虫病症状的妇女中采集了3份高浓度阴道拭子。用WMM、内部PCR和TV培养对拭子进行TV检测。使用Excel 2007、SPSS v16和Meta-disc软件对结果进行分析，以确定测试的诊断准确性。WMM的敏感性、特异性和kappa一致性分别为25%（95%CI 5.5-57.2%）、100%（95%CI 97-100）和0.38。PCR的相应值分别为91.7%（95% CI 61.5-99.8）、99.3%（95% CI 96-100）和0.91。在有TV症状的女性中，WMM的敏感性非常低，三分之二的患者漏诊，而内部PCR则高度敏感和特异。建议进行可行性研究，旨在将PCR工具纳入资源有限的环境中诊断TV感染的算法。本文的在线版本（doi：10.1186/s13104-017-2581-1）包含补充材料，可供授权用户使用。
Trichomonas vaginalis (TV) causes the Trichomoniasis Syndrome composed of vaginitis in women, urethritis in men and tube infection in both sexes. This infection is strongly associated with premature rupture of membranes, preterm delivery, low birth weight, promoting HIV sexual transmission and infertility. Prevention of these complications requires accurate early detection and effective treatment of infected individuals. In the resource limited settings, the wet mount microscopy (WMM) is often the only available test for laboratory detection of TV, but its accuracy and that of polymerase chain reaction (PCR) tools in Uganda remain poorly studied. The aim of this cross-sectional study was to compare the diagnostic accuracy of the WMM and PCR against culture as reference standard for the direct diagnosis of TV among symptomatic women. Three high vaginal swabs were collected from each of one hundred fifty women presenting with symptoms suggestive of active vaginal trichomoniasis at the sexually transmitted diseases clinic of Mulago National Referral Hospital Kampala, Uganda. The swabs were tested for TV with WMM, in-house PCR and TV culture. Results were analysed using excel 2007, SPSS v16, and Meta-disc software to determine the diagnostic accuracy of the tests. The sensitivity, specificity and kappa agreement of the WMM was 25% (95% CI 5.5–57.2%), 100% (95% CI 97–100) and 0.38, respectively. Corresponding values for the PCR were 91.7% (95% CI 61.5–99.8), 99.3% (95% CI 96–100) and 0.91, respectively. Among the TV symptomatic women, the sensitivity of the WMM was very low, with two-thirds of the patients missing a diagnosis while the in-house PCR was highly sensitive and specific. Feasibility studies aimed at incorporating PCR tools in algorithms for diagnosis of TV infection in resource-limited settings are recommended. The online version of this article (doi:10.1186/s13104-017-2581-1) contains supplementary material, which is available to authorized users.