Diagnostic accuracy of real-time polymerase chain reaction assay for the detection of Trichomonas vaginalis in clinical samples: A systematic review and meta-analysis

Background: Vaginal trichomoniasis is a highly prevalent parasitic infection associated with HIV acquisition and preterm birth. The ‘gold standard’ for its diagnosis requires 3–7 days to detect by culture. Rapid and accurate diagnosis, such as by nucleic acid amplification testing, is key to manage...

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Main Authors: Emmanuel O. Babafemi, Benny P. Cherian, Khalid Rahman, Gilbert M. Mogoko, Oluwatoyin O. Abiola
Format: Article
Language:English
Published: AOSIS 2025-04-01
Series:African Journal of Laboratory Medicine
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Online Access:https://ajlmonline.org/index.php/ajlm/article/view/2522
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author Emmanuel O. Babafemi
Benny P. Cherian
Khalid Rahman
Gilbert M. Mogoko
Oluwatoyin O. Abiola
author_facet Emmanuel O. Babafemi
Benny P. Cherian
Khalid Rahman
Gilbert M. Mogoko
Oluwatoyin O. Abiola
author_sort Emmanuel O. Babafemi
collection DOAJ
description Background: Vaginal trichomoniasis is a highly prevalent parasitic infection associated with HIV acquisition and preterm birth. The ‘gold standard’ for its diagnosis requires 3–7 days to detect by culture. Rapid and accurate diagnosis, such as by nucleic acid amplification testing, is key to manage the disease, and control and prevent its transmission. Aim: This review aimed to assess the overall accuracy of real-time polymerase chain reaction (RT-PCR)-based assays, for routine diagnosis of Trichomonas vaginalis in clinical vaginal samples from women with symptomatic/asymptomatic trichomoniasis, using Trichomonads culture as the gold standard. Methods: MEDLINE, PubMed, EMBASE, and other sources were used to search for included studies published between 01 January 1995 and 31 July 2023. The search terms ‘real-time polymerase chain reaction’, ‘real-time’, ‘polymerase chain reaction’, ‘Trichomonas vaginalis’, ‘trichomonas’, ‘vaginalis’, ‘humans’, ‘rt pcr’, ‘nucleic acid amplification test’, ‘NAAT’, ‘trichomonad culture’, ‘women’ were included. Summary estimates were calculated for the overall accuracy of the assay compared to Trichomonads culture as the reference standard. Meta-analysis was conducted using a bivariate meta-regression model. Results: Twenty-seven eligible studies met our inclusion criteria: sensitivity 99% (95% confidence interval [CI] 99–100), specificity 100% (95% CI 100–100), positive likelihood ratio 350.67 (167.42–734.49), negative likelihood ratio 0.02 (0.01–0.03), diagnostic odds ratio 23 064.05 (95% CI 8532.13–62 346.77), and area under receiver operating characteristics curve 0.99. There was significant heterogeneity in sensitivity and specificity (p  0.001). Conclusion: Our results suggested that RT-PCR assays could be useful for the diagnosis of vaginal trichomoniasis with high sensitivity and specificity. What this study adds: This article provides a comprehensive review of the effectiveness of RT-PCR assays for the diagnosis of trichomoniasis with high sensitivity and specificity in comparison to other methods in clinical laboratory practice. The goal is to present awareness/evidence that this assay is more accurate and rapid than other techniques.
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institution Kabale University
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2225-2010
language English
publishDate 2025-04-01
publisher AOSIS
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series African Journal of Laboratory Medicine
spelling doaj-art-d24f341f0cb84c91aef3f5c39b7a6e352025-08-20T03:53:02ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102025-04-01141e1e810.4102/ajlm.v14i1.2522495Diagnostic accuracy of real-time polymerase chain reaction assay for the detection of Trichomonas vaginalis in clinical samples: A systematic review and meta-analysisEmmanuel O. Babafemi0Benny P. Cherian1Khalid Rahman2Gilbert M. Mogoko3Oluwatoyin O. Abiola4Department of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, LiverpoolDepartment of Microbiology, Royal London Hospital, Barts Health NHS Trust, LondonDepartment of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, LiverpoolDepartment of Microbiology, IPP Pathology First, Dobson House, Bentalls, BasildonDepartment of Computer Science, Faculty of Science, Afe Babalola University, Ado EkitiBackground: Vaginal trichomoniasis is a highly prevalent parasitic infection associated with HIV acquisition and preterm birth. The ‘gold standard’ for its diagnosis requires 3–7 days to detect by culture. Rapid and accurate diagnosis, such as by nucleic acid amplification testing, is key to manage the disease, and control and prevent its transmission. Aim: This review aimed to assess the overall accuracy of real-time polymerase chain reaction (RT-PCR)-based assays, for routine diagnosis of Trichomonas vaginalis in clinical vaginal samples from women with symptomatic/asymptomatic trichomoniasis, using Trichomonads culture as the gold standard. Methods: MEDLINE, PubMed, EMBASE, and other sources were used to search for included studies published between 01 January 1995 and 31 July 2023. The search terms ‘real-time polymerase chain reaction’, ‘real-time’, ‘polymerase chain reaction’, ‘Trichomonas vaginalis’, ‘trichomonas’, ‘vaginalis’, ‘humans’, ‘rt pcr’, ‘nucleic acid amplification test’, ‘NAAT’, ‘trichomonad culture’, ‘women’ were included. Summary estimates were calculated for the overall accuracy of the assay compared to Trichomonads culture as the reference standard. Meta-analysis was conducted using a bivariate meta-regression model. Results: Twenty-seven eligible studies met our inclusion criteria: sensitivity 99% (95% confidence interval [CI] 99–100), specificity 100% (95% CI 100–100), positive likelihood ratio 350.67 (167.42–734.49), negative likelihood ratio 0.02 (0.01–0.03), diagnostic odds ratio 23 064.05 (95% CI 8532.13–62 346.77), and area under receiver operating characteristics curve 0.99. There was significant heterogeneity in sensitivity and specificity (p  0.001). Conclusion: Our results suggested that RT-PCR assays could be useful for the diagnosis of vaginal trichomoniasis with high sensitivity and specificity. What this study adds: This article provides a comprehensive review of the effectiveness of RT-PCR assays for the diagnosis of trichomoniasis with high sensitivity and specificity in comparison to other methods in clinical laboratory practice. The goal is to present awareness/evidence that this assay is more accurate and rapid than other techniques.https://ajlmonline.org/index.php/ajlm/article/view/2522trichomoniasistrichomonas vaginalisreal-time polymerase chain reaction assayvaginal swabssystematic reviewmeta-analysis.
spellingShingle Emmanuel O. Babafemi
Benny P. Cherian
Khalid Rahman
Gilbert M. Mogoko
Oluwatoyin O. Abiola
Diagnostic accuracy of real-time polymerase chain reaction assay for the detection of Trichomonas vaginalis in clinical samples: A systematic review and meta-analysis
African Journal of Laboratory Medicine
trichomoniasis
trichomonas vaginalis
real-time polymerase chain reaction assay
vaginal swabs
systematic review
meta-analysis.
title Diagnostic accuracy of real-time polymerase chain reaction assay for the detection of Trichomonas vaginalis in clinical samples: A systematic review and meta-analysis
title_full Diagnostic accuracy of real-time polymerase chain reaction assay for the detection of Trichomonas vaginalis in clinical samples: A systematic review and meta-analysis
title_fullStr Diagnostic accuracy of real-time polymerase chain reaction assay for the detection of Trichomonas vaginalis in clinical samples: A systematic review and meta-analysis
title_full_unstemmed Diagnostic accuracy of real-time polymerase chain reaction assay for the detection of Trichomonas vaginalis in clinical samples: A systematic review and meta-analysis
title_short Diagnostic accuracy of real-time polymerase chain reaction assay for the detection of Trichomonas vaginalis in clinical samples: A systematic review and meta-analysis
title_sort diagnostic accuracy of real time polymerase chain reaction assay for the detection of trichomonas vaginalis in clinical samples a systematic review and meta analysis
topic trichomoniasis
trichomonas vaginalis
real-time polymerase chain reaction assay
vaginal swabs
systematic review
meta-analysis.
url https://ajlmonline.org/index.php/ajlm/article/view/2522
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