A service evaluation of the Gen-Probe APTIMA nucleic acid amplification test for Trichomonas vaginalis: should it change whom we screen for infection?
Hathorn et al.
The finding, in our words
A service evaluation of the Gen-Probe APTIMA test at a UK sexual health clinic found Trichomonas vaginalis prevalence of 1.4% in men and 3.6% in women. Asymptomatic men provided self-collected first-void urine and asymptomatic women self-collected vulvovaginal specimens, and the study concluded that targeted screening of high-risk asymptomatic groups is more cost-effective than universal screening, supporting decentralised STI testing strategies.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
Routine clinic-based cervical sampling generated 3670 g CO2e per sample, whereas vaginal self-sampling produced 423 g CO2e and first-void urine collection produced 570 g CO2e. Decentralised self-collection approaches substantially lowered emissions by eliminating primary care clinic visits.
Whittaker et al., BJOG : an international journal of obstetrics and gynaecology (paywalled) · source ↗
First-void urine self-sampling for HPV screening cost £38.57 per complete screen compared with £56.81 for clinician-collected samples, with potential NHS savings of £19.2 million annually if uptake improved among non-attenders. This shows self-sampling is substantially cheaper and could expand screening reach to under-screened women, supporting decentralised diagnostic programmes.
Urine self-sampling for HPV detection showed good agreement with clinician-collected cervical samples (Kappa 0.72) under optimised conditions of 40 mM EDTA preservative, storage at 25°C, and processing within 72 hours. With a cost of USD 1.10 and high acceptability among women and healthcare workers, this method offers a practical decentralised screening approach for resource-limited settings.
The programme found that men prefer traditional healthcare settings for STI screening, yet community venues such as amateur football clubs were acceptable to about half of sports participants, with high uptake of urine-based screening across different promotional approaches. Self-sampling kits for STIs were highly acceptable, and accelerated partner therapy via telephone hotline or pharmacy assessment achieved partner treatment rates that, while below national standards, exceeded outcomes previously reported from community settings.
Estcourt et al., NIHR Journals Library, Southampton · source ↗
This meta-analysis found that HPV testing using self-collected vaginal and urine samples showed sensitivities of 88.6% and 81% for detecting cervical precancer. Using a standardised device for first-void urine increased sensitivity to 86.6%, supporting decentralised patient-centric screening, though data on specificity and specific commercial devices were not consistently reported.
Hsiao et al., The journal of obstetrics and gynaecology research (paywalled) · source ↗