Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional study

Abstract Background 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 tr...

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Main Authors: Sheila Nabweyambo, Othman Kakaire, Stefanie Sowinski, Alfred Okeng, Henry Ojiambo, Joshua Kimeze, Irene Najjingo, Freddie Bwanga
Format: Article
Language:English
Published: BMC 2017-07-01
Series:BMC Research Notes
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13104-017-2581-1
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spelling doaj-9883cace70304593b394cf59096e57eb2020-11-24T21:47:52ZengBMCBMC Research Notes1756-05002017-07-011011610.1186/s13104-017-2581-1Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional studySheila Nabweyambo0Othman Kakaire1Stefanie Sowinski2Alfred Okeng3Henry Ojiambo4Joshua Kimeze5Irene Najjingo6Freddie Bwanga7Department of Medical Microbiology, Makerere University College of Health SciencesDepartment of Obstetrics/Gynaecology, Makerere University College of Health SciencesInfectious Diseases Institute, Makerere University College of Health SciencesMBN Clinical LaboratoriesInfectious Diseases Institute, Makerere University College of Health SciencesInfectious Diseases Institute, Makerere University College of Health SciencesMBN Clinical LaboratoriesDepartment of Medical Microbiology, Makerere University College of Health SciencesAbstract Background 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. Results 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. Conclusion 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.http://link.springer.com/article/10.1186/s13104-017-2581-1Trichomonas vaginalisSexually transmitted infectionsTrichomoniasisWet mount microscopyPolymerase chain reaction
collection DOAJ
language English
format Article
sources DOAJ
author Sheila Nabweyambo
Othman Kakaire
Stefanie Sowinski
Alfred Okeng
Henry Ojiambo
Joshua Kimeze
Irene Najjingo
Freddie Bwanga
spellingShingle Sheila Nabweyambo
Othman Kakaire
Stefanie Sowinski
Alfred Okeng
Henry Ojiambo
Joshua Kimeze
Irene Najjingo
Freddie Bwanga
Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional study
BMC Research Notes
Trichomonas vaginalis
Sexually transmitted infections
Trichomoniasis
Wet mount microscopy
Polymerase chain reaction
author_facet Sheila Nabweyambo
Othman Kakaire
Stefanie Sowinski
Alfred Okeng
Henry Ojiambo
Joshua Kimeze
Irene Najjingo
Freddie Bwanga
author_sort Sheila Nabweyambo
title Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional study
title_short Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional study
title_full Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional study
title_fullStr Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional study
title_full_unstemmed Very low sensitivity of wet mount microscopy compared to PCR against culture in the diagnosis of vaginal trichomoniasis in Uganda: a cross sectional study
title_sort very low sensitivity of wet mount microscopy compared to pcr against culture in the diagnosis of vaginal trichomoniasis in uganda: a cross sectional study
publisher BMC
series BMC Research Notes
issn 1756-0500
publishDate 2017-07-01
description Abstract Background 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. Results 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. Conclusion 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.
topic Trichomonas vaginalis
Sexually transmitted infections
Trichomoniasis
Wet mount microscopy
Polymerase chain reaction
url http://link.springer.com/article/10.1186/s13104-017-2581-1
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