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A New Strategy for Trichomonas Testing Female Adolescents in the Emergency Department.

Abstract：

STUDY OBJECTIVE:Sensitive trichomonas diagnostic testing has become available, including nucleic acid amplification tests (NAATs) and a rapid antigen test. The study purpose was to determine if adding sensitive trichomonas testing to routine female sexually transmitted infection (STI) evaluations would increase trichomonas identification and treatment. DESIGN:Two study time periods. Study time 1 (T1) was used for a retrospective review. Study time 2 (T2) was used for a prospective study. SETTING:Emergency Department. PARTICIPANTS:Symptomatic female patients aged 13-20 years (N = 447). INTERVENTIONS:Implementation of routing trichomonas testing in the Emergency Department during T2. MAIN OUTCOME MEASURES:Trichomonas diagnosis and treatment rates were compared during T1 and T2. RESULTS:During T1 31 of 234 of eligible patients (13%) were trichomonas-tested. Laboratory-confirmed trichomonas was identified in 3 of 234 (1.3%). During T2, 212 of 213 of eligible patients (99.5%) were trichomonas-tested; 39 of 212 tested trichomonas-positive (18.4%); 29 of 212 tested rapid trichomonas antigen test-positive (13.6%; P < .001), and 33 of 188 tested trichomonas NAAT-positive (15.5%; P < .001). Trichomonas treatment was given to 3 of 3 laboratory-confirmed trichomonas cases during T1 (100%) compared with 37 of 39 during T2 (95%; P = .688). During T1, 14 of 17 women who received trichomonas treatment (82.4%) did not have a laboratory-confirmed trichomonas diagnosis and during T2 13 of 52 women without a laboratory-confirmed trichomonas diagnosis (25%) were treated for trichomonas (P < .001). Rapid trichomonas antigen tests and trichomonas NAATs were concordant in 178 of 188 patients (94.6%). CONCLUSION:Incorporating trichomonas rapid antigen tests and NAATs into routine female adolescent STI testing significantly increased the number of laboratory-confirmed adolescent trichomonas diagnosis and treatment and are useful Emergency Department STI screening tools.

journal_name

J Pediatr Adolesc Gynecol

journal_title

Journal of pediatric and adolescent gynecology

authors

Territo HM,Wrotniak BH,Bouton S,Burstein GR

doi

10.1016/j.jpag.2016.01.120

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

378-81

issue

4

eissn

1083-3188

issn

1873-4332

pii

S1083-3188(16)00147-9

journal_volume

29

pub_type

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