Diagnostic utility of vaginal cytology compared to wet smear cytology for detection of Trichomonas vaginalis infection among adult women at a tertiary care center: A diagnostic evaluation study

Abstract

Background: Trichomonas vaginalis is the most common nonviral sexually transmitted disease in the world. Objective: The present study compares PAP smear and wet smear cytology for the detection of T. vaginalis infection among women of aged 18 years and above in the rural population of Northern India. Materials and Methods: The present diagnostic evaluation study was conducted between January 2021 and January 2023. All women aged 18 years and above attending the gynecology outpatient department of Government Medical College Azamgarh, Uttar Pradesh India, with complaints of vaginal discharge were included in the study. A detailed history was taken, and vaginal cytology was done. Wet smear as well as PAP stained vaginal cytology were done, and data were tabulated and analyzed. Results: Out of 467 eligible patient’s analyzed T. vaginalis infection was seen in 22 patients by wet smear method and in 32 patients by vaginal cytology method, giving a prevalence of 4.7% and 6.8%, respectively, with both methods. T. vaginalis was most commonly prevalent in 25–30 years age groups. We found sensitivity, specificity, positive predictive value, and negative predictive value as 90.9%, 97.3%, 62.5%, and 99.5%, respectively, of vaginal cytology method (Index test) compared to wet smear cytology (gold standard test). Conclusion: Burden of T. vaginalis disease was 4.7% by wet cytology and 6.8% by vaginal cytology, with a sensitivity of 90.9% and specificity of 97.3% compared to the gold standard test in the rural population of Northern India. Wet smear cytology is the gold standard to diagnose T. vaginalis and is a preferable test considering the cost and availability. Results of vaginal cytology were comparable to wet smear cytology as there was no statistical significance between the two test.

Keywords

• diagnostic test
• sexually transmitted infections
• trichomonas vaginalis
• vaginal cytology
• wet smear