Diagnostic Accuracy of Rapid Antigen Tests for Trichomoniasis: A Meta-Analysis

Trichomoniasis is a globally prevalent sexually transmitted infection caused by the protozoan Trichomonas vaginalis . Polymerase chain reaction (PCR) is the gold standard for diagnosing trichomoniasis, but it is expensive. Antigen tests are immunochromatographic immunoassays that detect T. vaginalis membrane proteins. Despite being user-friendly and rapid, the diagnostic accuracy of antigen tests remains uncertain. Therefore, this meta-analysis aimed to evaluate the diagnostic accuracy of antigen tests for T. vaginalis infections.

The authors mined the PubMed, Embase, and Cochrane Library databases for studies evaluating the diagnostic accuracy of antigen tests for T. vaginalis . They included studies that provided diagnostic test accuracy data in order to conduct a meta-analysis. They evaluated antigen tests based on immunochromatography and lateral flow devices. The meta-analysis was conducted by using the hierarchical summary receiver operating characteristic model.

Eleven studies with 5,884 samples were included. The meta-analysis yielded a pooled sensitivity of 87.0% and a pooled specificity of 98.3%. A subgroup analysis employing PCR as the reference standard yielded a sensitivity of 58.5%, whereas another subgroup analysis using culture returned a sensitivity of 95.9%. The subgroup analysis of 6 studies comprising 2,328 specimens from symptomatic individuals yielded a pooled sensitivity of 85% and a specificity of 99.9%.

The antigen tests exhibited high sensitivity and specificity. Additionally, subgroup analyses revealed that antigen tests demonstrated greater sensitivity in diagnosing symptomatic patients compared to asymptomatic individuals. While less sensitive than PCR, antigen testing remains a promising avenue for detecting T. vaginalis infections.