Diagnostic evaluation of the BD Affirm VPIII assay as a point-of-care test for the diagnosis of bacterial vaginosis, trichomoniasis and candidiasis

Untreated sexually transmitted infections and bacterial vaginosis (BV) pose a serious health risk to mother and child. Limited data exist on the use of the BD Affirm™ VPIII assay as a point-of-care test (POCT). The performance of the BD Affirm™ VPIII assay was compared with the BD Max™ vaginal assay for the diagnosis of BV, Trichomonas vaginalis (TV) and Candida spp. A total of 273 pregnant women were enrolled in this study and had provided two self-collected vaginal swabs. Sensitivity, specificity, positive predictive value, negative predictive value and prevalence were calculated. The prevalence of BV, candidiasis and trichomoniasis was 49.4, 57.2 and 10.3%, respectively. The BD Affirm™ VPIII assay showed a moderate sensitivity (79.8%) and a moderate specificity (80.3%) for diagnosing BV in all participants. The BD Affirm™ VPIII assay had an excellent specificity for Candida spp. and TV of 97.4 and 100%, respectively; however, the assay exhibited poor sensitivities of 52.9 and 46.4%, respectively. This study was the first to report on the performance of the BD Affirm™ VPIII assay as a POCT in an antenatal population. The assay was found to be unsuitable as a screening test for vaginal infections in pregnancy.

Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016

OBJECTIVE

To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15-49 years, in 2016.

METHODS

For chlamydia, gonorrhoea and trichomoniasis, we systematically searched for studies conducted between 2009 and 2016 reporting prevalence. We also consulted regional experts. To generate estimates, we used Bayesian meta-analysis. For syphilis, we aggregated the national estimates generated by using Spectrum-STI.

FINDINGS

For chlamydia, gonorrhoea and/or trichomoniasis, 130 studies were eligible. For syphilis, the Spectrum-STI database contained 978 data points for the same period. The 2016 global prevalence estimates in women were: chlamydia 3.8% (95% uncertainty interval, UI: 3.3-4.5); gonorrhoea 0.9% (95% UI: 0.7-1.1); trichomoniasis 5.3% (95% UI:4.0-7.2); and syphilis 0.5% (95% UI: 0.4-0.6). In men prevalence estimates were: chlamydia 2.7% (95% UI: 1.9-3.7); gonorrhoea 0.7% (95% UI: 0.5-1.1); trichomoniasis 0.6% (95% UI: 0.4-0.9); and syphilis 0.5% (95% UI: 0.4-0.6). Total estimated incident cases were 376.4 million: 127.2 million (95% UI: 95.1-165.9 million) chlamydia cases; 86.9 million (95% UI: 58.6-123.4 million) gonorrhoea cases; 156.0 million (95% UI: 103.4-231.2 million) trichomoniasis cases; and 6.3 million (95% UI: 5.5-7.1 million) syphilis cases.

CONCLUSION

Global estimates of prevalence and incidence of these four curable sexually transmitted infections remain high. The study highlights the need to expand data collection efforts at country level and provides an initial baseline for monitoring progress of the World Health Organization global health sector strategy on sexually transmitted infections 2016-2021.

PREVALENCE OF TRICHOMONIASIS IN ASYMPTOMATIC PREGNANT WOMEN POPULATION IN BANDUNG, WEST JAVA, INDONESIA

About 81% of pregnant women with trichomoniasis are asymptomatic, while trichomoniasis in pregnant women can increase the risk of complications, include premature rupture of membranes, preterm birth, and babies with low birth weight. Trichomoniasis can also increase the risk of other sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) transmission. Trichomoniasis case in pregnant women could be influenced by demographic characteristics,, the sexual behavior, and also the diagnostic method used. Until now, there is no data about prevalence of trichomoniasis in pregnant women in Indonesia. The aim of this research was to determine the prevalence of trichomoniasis in pregnant women in Bandung, West Java, Indonesia. A descriptive cross-sectional study was performed in December 2016 until January 2017. The study participants were 50 pregnant women who visit antenatal care to Obstetric and Gynecology Clinic of ’Rumah Sakit Khusus Ibu dan Anak Kota Bandung’, and meet the inclusion and exclusion criteria, through consecutive sampling. The study participants had a history taking, venereological examination, and Trichomonas rapid test from vaginal swabs. Trichomoniasis in this study was diagnosed based on Trichomonas rapid test, a test that uses color immunochromatographic, capillary flow, dipstick technology, and has high sensitivity and specificity in diagnosing trichomoniasis. Almost all participants in this study were low risk pregnant women to have STI based on demographic characteristics and sexual behaviour. The positive Trichomonas rapid test result was found from one of 50 study participants. In conclusion, prevalence of trichomoniasis in pregnant women in Bandung was 2%. Trichomoniasis case in low-risk pregnant women population is still found.