ABSTRACT

van de Wijgert, Janneke, Lydia Altini, Heidi Jones, Alana de Kock, Taryn Young, Anna L. Williamson, Anwar Hoosen, and Nicol Coetzee. 2006. "Two methods of self-sampling compared to clinician sampling to detect reproductive tract infections in Gugulethu, South Africa," Sexually Transmitted Diseases 33(8): 516–523.

Objectives
To assess the validity, feasibility, and acceptability of two methods of self-sampling compared to clinician sampling during a speculum examination.

Goal
To improve screening for reproductive tract infections (RTIs) in resource-poor settings.

Study design
In a public clinic in Cape Town, 450 women underwent a speculum examination and were randomized to self-sample with either a tampon or vaginal swabs. All specimens were tested for the same pathogens using the same diagnostic tests.

Results
Self-sampling resulted in satisfactory validity for N. gonorrhoeae, C. trachomatis, bacterial vaginosis, and Candida species (tampons and swabs) and high-risk human papillomavirus (swabs only) when tested with molecular tests or microscopy, but not for T. vaginalis by culture. Self-sampling was feasible and acceptable, but some women preferred speculum examinations, which allow the clinician to view the vagina and cervix.

Conclusions
Although self-sampling should not replace speculum examinations in all circumstances, it should be explored further as an RTI screening strategy.

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