Trichomoniasis: Sensitivity and Specificity

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

Prevalence

Population / Calculator	Prevalence	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.
	66%
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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	Sensitivity	Specificity	Comments, Study
Affirm VP III Microbial Identification System	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	98%	98%	Study: PMID: 17578778
OSOM Trichomonas Rapid Test	88%	98%	Dipstick assay that takes 10" to read. Study: PMID:15695664
Culture on Diamond's Medium	95%	95%	Study: UptoDate: http://www.uptodate.com/online/content/topic.do?topicKey=gen_gyne/28379&selectedTitle=1~30&source=search_result

Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Clinical diagnosis	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	61%	99%	Study: Study: Am J Obstet Gynecol. 2003 Feb;188(2):354-6; PMID: 12592239
Trichomonads on liquid-based Pap smear	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	Sensitivity	Specificity	Comments, Study
Vaginal pH	56%	50%	pH >4.5 Study: Hopkins Antibiotics Guide
Wet Mount	Sensitivity = 65%		of vaginal discharge, looking for motile trichomonads Study: Hopkins Antibiotics Guide
Strawberry Cervix	Sensitivity = 5%		specificity not mentioned Study: Hopkins Antibiotics Guide