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Good Positive and Negative Likelihood Ratios

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Trichomoniasis: Likelihood Ratios

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

[Edit Diagnosis] [Merge dx] [Add prevalence]

Tags: Gynecologic Infection Tag this Diagnosis.

Prevalence

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.

66%
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The likelihood ratios of findings for Trichomoniasis are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding +LR-LR Comments, Study
Transcription-mediated amplification testing Edit 490

Study: PMID: 17578778

Affirm VP III Microbial Identification System Edit 900.1

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

Study: PMID:8623867

OSOM Trichomonas Rapid Test Edit 440.1

Dipstick assay that takes 10" to read.

Study: PMID:15695664

Culture on Diamond's Medium Edit 190.1

Study: UptoDate:

http://www.uptodate.com/online/content/topic.do?topicKey=gen_gyne/28379&selectedTitle=1~30&source=search_result

Clinical diagnosis Edit 211.50.2

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 610.4

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

Trichomonads on liquid-based Pap smear Edit 190.4

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 +LR-LR Comments, Study
Vaginal pH Edit 1.10.9

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