Systematic review of diagnostic tests for vaginal trichomoniasis.

Objective: To review critically and to summarize the evidence of diagnostic tests and culture media for the diagnosis of Trichomonas vaginitis. Methods: We performed a systematic review of literature indexed in MEDLINE of studies that used Trichomonas culture as the reference standard (9 882 patients 35 studies). Level I studies (5 047 patients 13 studies) fulfilled at least two of three criteria: 1) onsecutive patients were evaluated prospectively 2) decision to culture was not influenced by test results and 3) there was independent and blind comparison to culture. Results: The sensitivity of the polymerase chain reaction technique (PCR) was 95% (95% CI 91% to 99%) and the specificity was 98% (95% CI 96% to 100%). One study was classified as Level I evidence (52 patients). The sensitivity of the enzyme-linked immunosorbent assay was 82% (95% CI 74% to 90%) and the specificity was 73% (95% CI 35% to 100%). The sensitivity of the direct luorescence antibody was 85% (95% CI 79% to 90%) and the specificity was 99% (95% CI 98% to 100%). Sensitivities of culture media were 95% for Diamond’s 96% for Hollander and 95% for PLM. Conclusions: The sensitivity and specificity of tests to diagnose trichomoniasis vary widely. Originally published Infectious Diseases in Obstetrics and Gynecology Vol. 8 No. 5-6 200