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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.

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.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Specific Findings
Finding	Result	Sensitivity	Specificity
[ + ] Clinical diagnosis	+ 0 -	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	+ 0 -	61%	99%
Study: Study: Am J Obstet Gynecol. 2003 Feb;188(2):354-6; PMID: 12592239
[ + ] Trichomonads on liquid-based Pap smear	+ 0 -	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	Result	Sensitivity	Specificity
[ + ] Vaginal pH	+ 0 -	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