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Trichomoniasis: Sensitivity and Specificity

Introduction: Trichomoniasis is a common sexually transmitted disease caused by Trichomonas vaginalis.

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Tags: Gynecologic Infection Tag this Diagnosis.


Population / CalculatorPrevalence Comments / Study / Link
Women age 14-49, United States 3% Trichomonas vaginalis infection detected by PCR of self-collected vaginal swabs by 3754 women.

Clin Infect Dis. 2007 Nov 15;45(10):1319-26.

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The sensitivity and specificity of findings for Trichomoniasis are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding SensitivitySpecificity Comments, Study
Affirm VP III Microbial Identification System Edit 90%99%

Compared with culture on Diamond's medium and wet-mount identification of T. vaginalis. Test takes 45" to read.

Study: PMID:8623867

Transcription-mediated amplification testing Edit 98%98%

Study: PMID: 17578778

OSOM Trichomonas Rapid Test Edit 88%98%

Dipstick assay that takes 10" to read.

Study: PMID:15695664

Culture on Diamond's Medium Edit 95%95%

Study: UptoDate:

Specific Findings

Finding SensitivitySpecificity Comments, Study
Clinical diagnosis Edit 84.6%99.6%

The clinical examination included a speculum examination for observation of mucopurulent cervicitis and evaluation of secretions for color, viscosity, and homogeneity. Vaginal specimens were collected for wet-prep microscopy (normal saline and 10% potassium hydroxide slides), whiff (amines) test using 10% potassium hydroxide added to the vaginal secretions, and determination of vaginal secretion pH (Phenazine Paper, Decon Laboratories, Inc., King of Prussia, PA).

Study: Obstet Gynecol. 2009 Jan;113(1):89-95. PMID: 19104364

Trichomonads on liquid-based Pap smear Edit 61%99%

Study: Study: Am J Obstet Gynecol. 2003 Feb;188(2):354-6; PMID: 12592239

Trichomonads on liquid-based Pap smear Edit 57%97%

Incidental finding on Pap smear.

Recommend treatment if prevalence of trichomoniasis is >= 20%.

Based on meta-analysis of multiple studies, 1976-1998.

Study: Am J Med. 2000 Mar;108(4):301-8; PMID: 11014723

Poorly Diagnostic Findings

Finding SensitivitySpecificity Comments, Study
Vaginal pH Edit 56%50%

pH >4.5

Study: Hopkins Antibiotics Guide

Wet Mount Edit Sensitivity = 65%

of vaginal discharge, looking for motile trichomonads

Study: Hopkins Antibiotics Guide

Strawberry Cervix Edit Sensitivity = 5%

specificity not mentioned

Study: Hopkins Antibiotics Guide