Trichomoniasis Diagnosis: Fresh Examination, Molecular Tests, and Rapid Testing for Vaginal Discharge

Trichomoniasis is one of the most common sexually transmitted infections worldwide, caused by the flagellated protozoa Trichomonas vaginalis. Despite its high prevalence, trichomoniasis diagnosis remains a challenge due to the variability of symptoms and the lack of universal diagnostic methods. Traditionally, the fresh examination has been the most utilized method, although its sensitivity is limited. In recent years, molecular tests have emerged as a more accurate and reliable alternative.
Fresh Examination and Molecular Tests: A Comparative Approach
The fresh examination involves the direct observation of a sample of vaginal discharge under the microscope to identify the presence of Trichomonas vaginalis. While it is a quick and cost-effective method, its sensitivity is low, detecting only a limited percentage of positive cases. A study conducted in the United Kingdom demonstrated that the sensitivity of the fresh examination is 38%, significantly lower than other diagnostic methods [1].
On the other hand, molecular tests, such as nucleic acid amplification, have shown much higher sensitivity and specificity. The use of techniques like PCR and the Aptima T. vaginalis assay has proven to be highly effective, with sensitivities reaching 100% in some studies [2]. Additionally, innovative methods like MIRA-CRISPR/Cas13a-LFD offer rapid and precise detection, significantly improving the management of the infection [3].
Conclusions
Accurate trichomoniasis diagnosis is crucial for effective treatment and the prevention of associated complications. Although the fresh examination remains a useful tool in resource-limited settings, molecular tests offer greater accuracy and should be considered the gold standard in diagnosing this infection. The implementation of these advanced technologies can significantly improve the detection and management of trichomoniasis, thereby reducing its impact on public health.
Referencias
- [1] Microscopy outperformed in a comparison of five methods for detecting Trichomonas vaginalis in symptomatic women.
- [2] Molecular testing for Trichomonas vaginalis in women: results from a prospective U.S. clinical trial.
- [3] A novel detection method based on MIRA-CRISPR/Cas13a-LFD targeting the repeated DNA sequence of Trichomonas vaginalis.
Created 6/1/2025