Comparison of self-obtained penile-meatal swabs to urine for the detection ofC. trachomatis,N. gonorrhoeaeandT. vaginalis

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Abstract
Background: Self-obtained penile-meatal swabs and urine specimens have been used forChlamydia trachomatis(CT),Neisseria gonorrhoeae(NG) andTrichomonas vaginalis(TV) for outreach screening in men.Objective: To compare the sensitivity of self-collected male penile-meatal swabs and urine for the detection ofCT,NGandTV.Methods: Matching penile-meatal swabs and urines were collected at home after recruitment to the study; via the internet programme,http://www.iwantthekit.org. The instructions directed the participant to place the tip of a Copan flocked swab at the meatal opening of the urethra to collect the penile-meatal sample. Two ml of urine was collected after the swab onto a Copan sponge-on-a-shaft collection device. Both swab and urine were placed into individual Aptima transport media tubes and mailed to the laboratory for testing. All specimens were tested for CT and NG using the GenProbe Aptima Combo2 Assay and for TV using GenProbe Aptima Analyte Specific Reagents with TV oligonucleotides.Results: Of 634 men, 86 (13.6%) were positive for CT, 9 (1.4%) were positive for NG and 56 (9.3%) positive for TV. For CT, swab sensitivity was 81/86 (94.2%), and urine sensitivity was 66/86 (76.7%). For NG, swab sensitivity was 9/9 (100%) and urine sensitivity was 8/9 (88.9%). For TV, swab sensitivity was 45/56 (80.4%) and urine sensitivity was 22/56 (39.3%).Conclusions: Self-obtained penile-meatal swabs provided for the detection of more CT, NG and TV, than urine specimens.

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