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Background:
TV diagnosis is often based on microscopy exam of vaginal secretions with poor sensitivity. The OSOM Trichomonas Rapid Test (TRT; Sekisui Diagnostics) is a CLIA-waived, rapid test with sensitivity >83% and results in 10 minutes. The study purpose was to determine if adding TV testing to all routine ED STI evaluations increased TV identification and treatment.
Methods:
Setting: Western New York State urban, children’s hospital ED
Population: 13 – 20 year old females presenting to ED for STI testing
Time periods: Study Time 1 (T1): 4/11-9/11(prior to routine TV ED STI testing);
Study Time 2 (T2): 11/11-10/12 (after routine TV ED STI testing implemented).
Methods: We performed a retrospective review during T1 of consecutive medical records of eligible patients.
We conducted a prospective study during T2 of enrolled females for STIs. TRTs and TV nucleic acid amplification tests (NAAT; Aptima, GenProbe) were ordered for enrolled patients.
Chi-square tests and logistic regression were used to assess statistical significance.
Results:
During T1, 234 female ED patients met study inclusion criteria, 13% (31/234) were TV tested with 1.3% (3/234) testing positive. During T2, 213 females were enrolled; 99.5% (212/213) were TV tested; 13.6% (29/213) tested TRT positive (p<.001) and 17.6% (33/188) tested TV NAAT positive (p<.001). TV treatment was given to 7% (17/234) of patients during T1 compared to 24% (52/213) during T2 (p<.001).
TRT and NAAT TV testing were concordat in 94.6%(178/188) of patients. Of these 188 tests, thirty percent (10/33) of positive TV NAATs were TRT negative.
Using logistic regression, we found no statistical significant trichomonas clinical predictors.
During T2, 26 males were enrolled; 77% (20/26) were TV tested; 8% (2/26) tested positive.
Conclusions: Incorporating TRTs and TV NAATs into routine adolescent STI testing significantly increased adolescent TV diagnosis and treatment and are important tools for STI screening in urban EDs.